BSN as entry into practice; why we decided against it. - page 5

by MunoRN

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 SummitAP
    In the medical fields, there is but one other field besides nursing that hasn't realized the improved patient care and higher salary comes with higher education, understanding deeply the why, the research, and broadening scope and field.
    *** I would add another field. PAs can enter the profession at several levels from associates to masters.
    Kandy83 likes this.
  2. 0
    I don't see how they will be able to require advanced practice nurses to have doctorate degrees without also raising the requirements of RN's. If they do actually require a NP to have a doctorate to practice then I'd be willing to bet the BSN requirement will be close behind. It only makes sense.
  3. 1
    Quote from PMFB-RN
    *** Magnet has not required a hospital to staff BSN RNs or a percentage of BSN RNs at the bedside. All 3 magnet hospital in my state recruit and hire associates degree nurses. Only one of the three, the one associated with the university school of nursing, even says "BSN prefered". One of those hospitals will only consider associates new grads for it's Critical Care Residency for the SICU (due to so few BSN grads completing their contract).

    I wasn't able to read the Medscape article but it would seem that it is evidence that Magnet certification results in lower moretality rates but says nothing about BSN vs ADN RNs.
    Right about the first part. As of now the BSN requirement applies only to nurse managers.

    From the ANCC website:

    Effective 1/1/2011 (at time of application) – 75% Nurse Managers must have a degree in nursing
    (baccalaureate or graduate degree)
    Effective 1/1/2013 (at time of application) – 100% Nurse Managers must have a degree in nursing
    (baccalaureate or graduate degree)


    But after 2013 magnet hospitals will have to present a plan to have 80% of all RNs with BSNs.

    Organizations submitting documentation anytime on or after June 1, 2013, regardless of the application date, will be expected to address the new education SOE: "Provide an action plan and set a target, which demonstrates evidence of progress toward having 80% of registered nurses obtain a degree in nursing (baccalaureate or graduate degree)by 2020."

    Source: Magnet Recognition Program® FAQ: Data and Expected Outcomes - American Nurses Credentialing Center - ANCC
    SummitRN likes this.
  4. 7
    Quote from PRICHARILLAisMISSED
    Not sure how true this is, but the College that I am currently working towards My ADN with claims that they have a significantly higher pass rate of the NCLEX than the 4 yr University's BSN graduates do. So I guess the real question would be "How accurately does the NCLEX test those entering the nursing profession?" If the NCLEX is a fair gauge of a new grads knowledge, then I would the imagine that the BSN would not be necessary for an entry level Nursing position. It MAY, however be necessary to pick up a management position...
    The NCLEX tests at the Minimal level for entry into practice. So, comparing the scores is a moot point. My argument for a push for a BSN for entry into practice has nothing to do with whether or not a BSN can start an IV better than an ADN. It is more complicated then that. We have fought for the validation of the nursing profession for how many years? I feel that a bachelor's degree should be the minimum. We are on a playing field with many different providers in medicine. We need to be able to justify our level of autonomy among other aspects of our career.
    Maritimer, LibraSunCNM, llg, and 4 others like this.
  5. 0
    Why even fight about it. When the fiscal cliff hits- BSN's and ADN's will be laid off. Thank you corporate America.
  6. 2
    Quote from PureLifeRN
    I cant stand this type of argument. Why is it always assumed that BSN's DONT know what they are doing?!? All these posts from ADN's stating "My ADN school had more clinical hours", "My community college school is sooooo much better than the university." "ADN's know more than BSN's"

    Well how about this? MY BSN school has more clinical hours, better NCLEX pass rate and prepares students to be better nurses than the local community college.....but no, that would be an inflammatory remark.
    Not to rain on your parade but an ADN RN is done with school and working sooner than the BSN RN, gaining real life work experience which is obviously superior to clinicals, plus making money sooner and carrying less student loan debt. What's not to like about this scenario? In this day and age of shrinking benefits, pensions, health insurance, it's a very smart decision to keep costs low and maximize income!

    BSN is just another credential, it may improve job opportunities, but it carries with it outsize student loan debt and for most jobs no extra income. The only ones I know who pay more for a BSN is the VA, govt and military. The private companies may prefer a BSN for Magnet status, but are the last to pay any extra to the BSN RN, as it will get in the way of their profits and bonuses for the CEO and his buddies!

    Just remember student loans have no consumer protections, cannot be discharged in bankruptcy, if you default you will still pay for them eventually plus a 25% fee and all the capitalized interest and they will garnish your social security, income tax refunds and wages. Putting your student loans into deferrment or forbearance only allows the interest to capitalize making the student loan grow exponentially. If you let your student loans default you can end up losing your license to practice and thereby your ability to work. Any job that requires a license to practice will not be an option for you and there are many jobs that require licenses even something like beautician or bartender!

    Instead of making this a contest about who is the better nurse one needs to think about what the best course of action is for themself and their family and I think the best way to protect oneself in this economy is to keep debts low and to avoid or minimize student loans that are the most dangerous loan out there!
    Last edit by brandy1017 on Nov 18, '12
    tewdles and redhead_NURSE98! like this.
  7. 4
    The same people who will defend associate's degrees to the death are often the same people who gripe about not being seen as a "professional."

    So, you want to be seen as a professional, but you want to keep the training at the technical school level? How many professionals go to community college?

    Most of the people who go to the community college around here are going to be some sort of tech/assistant, or to be a welder, auto repairman, or just as a stepping stone to the University.

    I don't really care what path anyone chooses, but until we are on the same playing field with other professions (which require at LEAST a bachelor's degree) then it's really pointless to complain about or demand more wages (notice I didn't say salary), respect, etc.
  8. 3
    Again, there's little doubt that the current BSN curriculum model is better than the 1965 ADN model, which is what some posters seem to be comparing. However, over the past 40 years ADN programs have progressively co-opted the BSN model, to the point were many ADN programs, through their affiliations with BSN programs, are now just satellite BSN programs that are located on CC campuses. These affiliated programs share the same pre-reqs, curriculum, and standards as their affiliated BSN programs, minus the general university requirements for a bachelor's degree and the additional leadership and community health class. Given this progression in ADN programs, it's unlikely that shutting them down and doubling the seats in direct BSN programs (as well as doubling the demand for their already overburdened clinical placement) will produce major improvements in practice.

    I'm skeptical of the idea that changing the level of entry will affect pay. If Baristas decide they're going to all get PhD's, it's unlikely that will improve their pay; it's market driven. (I was going to use the example of Bachelor's degrees but I think most baristas already have one). If shifting to a BSN increased pay, then we should have already seen an increase relative to other healthcare specialties. Instead, Nursing salary growth has lagged behind other specialties for which the educational requirement have remained a 1 or 2 year program, even though the number of BSN Nurses has significantly increased.

    There is some real potential to increase our market value in the future, but simply paying more for the same education won't do that. The predictions of the IHI's Transforming Care and the Bedside will likely come true, at least for the most part. With this will come increased market demand, which will then produce both changing educational demands as well as changing pay, but without changing market demand, it's unlikely that changing educational demand alone will affect pay. This is where an upward shift in educational requirements makes much more sense when done from the top down, as opposed to the bottom up. Raising the the NP from Masters to Doctoral will help NP's move into roles traditionally held by MD's, we've already seen this shift occur. There are many roles that Nurses are already in or would be good "fit"s for that would benefit from masters level education. Then as RN's move into more primary care, care coordination, etc. the BSN requirement would rise to meet demand, rather than the other way around.
  9. 0
    Most baristas already have a bachelor's degree? We're talking a coffee server, right?
  10. 2
    Quote from Ntheboat2
    The same people who will defend associate's degrees to the death are often the same people who gripe about not being seen as a "professional."

    So, you want to be seen as a professional, but you want to keep the training at the technical school level? How many professionals go to community college?

    Most of the people who go to the community college around here are going to be some sort of tech/assistant, or to be a welder, auto repairman, or just as a stepping stone to the University.



    What you are saying is TECHNICALLY true, Ntheboat2, but that just doesn't matter. It is also technically true that motorcycles are generally quicker than cars, and that statement has just as much relevance to this discussion as your above statement "I don't really care what path anyone chooses, but until we are on the same playing field with other professions (which require at LEAST a bachelor's degree) then it's really pointless to complain about or demand more wages (notice I didn't say salary), respect, etc.
    ."

    I say this because, "So what if those other professionals all have to have a Bachelor degree as an entry requirement." This is because the education and skills covered in those Bachelor degree programs in their entirety are necessary to do the job. But if there is decade upon decade of evidence telling us that ADN grads can carry out the job as well as (or for the sake of argument, in the ballpark of) BSN grads, then the entirety of a BSN curriculum is obviously NOT the necessary entry requirement of the field. You argue that Nurses should get a mandatory BSN for pretty much no other reason than because "They have it, why shouldn't Nurses have it?" I mean if that's the case, why not make a Triple Doctorate the entry level requirement with a "Nobel in 10" to follow as a condition of continued employment? That'll sure show those other professions how seriously they should take Nursing!

    BTW, If you are paid hourly, you are a wage earner, It doesn't matter what your employer or anyone else calls it. Salary is a yearly base pay.

    Also, I'd like to point out that this post could be taken a bit as an insult for the recipient, so let me add that that is not my intention, but as I lack the ability to get my point across in any other way this is the best I could do.
    tewdles and tokmom like this.


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