BSN to practice ethical dilemma - where do you stand?

  1. This debate is decades old and unresolved still. I would love any perspectives voiced as to why you are FOR or AGAINST having a BSN required in order to enter practice as an RN.

    For the record I am against it.... feeling that we should be granted a grace period of ten years to aquire a BSN if we want to with some sort of reasonable incentive to do so. The wage increase is not enough to make the cost of schooling make sense for at least 10-15 years and we are in a country where grants and scholarships are hard work too. The lag time of implementing this would worsen the nursing shortages too and some of the best nurses I know are not highly "degreed"...

    What are your feelings on this?
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    About sowelu88

    Joined: Apr '08; Posts: 6; Likes: 3


  3. by   classicdame
    why is this an ethical dilemma? Sounds more economic.

    Sorry, I just don't follow your train of thought.
  4. by   MOMTOFIVE
    A couple of the reasons behind requiring a BSN for entry into nursing are: all other professions require at least a four year degree for entry into practice, some research has shown that patient outcomes are better with a higher ratio of BSN prepared nurses on the unit, and to further nursing research an understanding of the research process and the ability to critique studies is needed. I understand this does not address the nursing shortage but a think they are strong rationales for a BSN for entry into practice.
  5. by   squee-gee
    I'll be graduating with my ADN in a few weeks and I'm proud of it. Our program is excellent, and we are well known among our clinical sites for being well prepared (in some cases, the nurses we worked with felt we were better prepared than the students from the local 4-year program). Yes, I will probably go on to get my BSN, but until then I will be giving as good patient care as any other newly graduated registered nurse.

    ADN programs are vital for getting non-traditional students like myself into nursing. With the nursing shortage projected to get worse in the next decade, ADN programs fill a critical need. And please remember - ADN, BSN or diploma program, we all take the same NCLEX exam!
  6. by   ChristineN
    I'm getting ready to graduate from a diploma RN program and I can not even imagine getting a BSN right away. To me, the clinical hours I got in my program plus clinical experiences are much more than that of local BSN programs. Yes, BSN grads have a more liberal arts education, but is that really going to help them on the floor right out of school? I'd take a diploma or ADN grad any day.
  7. by   Alternator81
    This is always a great way to start contraversy on this forum. Just as a previous poster wrote, I believe that the entry for an RN should be a bachelors degree because it is important for the profession. This does not mean that an ADN is any less capable of doing what the BSN does or visa versa. It the fact that a bachelors is a professional degree. Every other profession requires a bachelors for entry into a career.

    It is the same reason that NPs are being phased out and DNP is replacing it. It is important for nurses to be on the same education level as other HC professionals they work with.
  8. by   manofcare
    Just for the record, an ADN program is a four year program if you count the hours of prereqs needed to have before the program. Second, the students that transition into the BSN program from other degree programs still have a BSN, yet according to the HESI results do far worse on grades than do ADN students. The wage difference between ADN and BSN will barely buy a package of gum, so here's my point. If the value of a BSN other than administrative needs are so much higher, then why is there no increase in pay for a nurse with a BSN? And, will this really help with a shortage that we have for nurses right now? No. I really have seen some good LVNs where I work, very competent and clinically savvy. Personally, I really am not interested in a BSN at this point other than a management position in the future.
  9. by   MB37
    Depending on how you look at it, requiring a BSN for entry could actually INCREASE the number of nurses out there (as long as current RNs with any level of education were grandfathered) by increasing the prestige of the profession. I have a previous BS, and I would never have considered any career choice or further education that wouldn't have provided at least another bachelor's degree. I never considered nursing out of high school because I didn't really know what nurses did, and I didn't think of it as a profession. I obviously no longer feel that way, but I do think that requiring the BSN for entry would improve the prestige of the profession.

    In no way do I mean to intimate that LPNs or RNs who came into the field via other routes are bad nurses or were poorly educated - I'm sure some of the CC programs out there are fantastic, and probably quite a few are better than mine as far as teaching actual nursing practice is concerned. I'm just saying that there are many people like me who feel pressured by family or by ourselves to be "professional," and well educated, and if that was the standard view of nursing in the community we might get more of the best and brightest into the field. Usually I don't comment on these types of threads, even though it's something I feel really strongly about. I wrote my term paper last semester on whether or not having more BSN nurses on the floor improved patient outcomes, and according to my research, it seems to - although my conclusion was that there still hasn't been enough research to recommend an overhaul of the entire educational system. Check out some of Linda Aiken's research for more info.
  10. by   sowelu88
    The economics of the situation is part of the ethical dilemma... definitely; and true maybe it is very astute of you to notice that it is just economics and the feeding of a system that is driven by the desire to "degree-up". The fact that this is presented to students at the ADN level as an ethical issue to be debated (I am preparing for a debate soon on this topic) is more due to nursing has been outstanding in its delivery over time to changing how the art of medicine is practiced and how nursing has contributed to better medicine practices all through the test of time. Why NOW do we need to degree up? ... because a study says so...the answer is not so clear to everyone and that is why it is presented as an ethical issue.
  11. by   Italia13 RN
    Quote from sowelu88
    Why NOW do we need to degree up? ... because a study says so...
    Why now? They have been trying to make the nursing entry level B.S.N for years, and it is not degreeing up as you say. Every other health profession has an ENTRY LEVEL, examples: PT~ doctorate and OT~ at least Masters, so why shouldn't Nursing??? Oh right the "Nursing Shortage", here is my opinion on that....There is only a nursing shortage at hospitals where no one wants to work, whether it be from salary not being good enough, mandatory OT, nurse pt ratio being ridiculous....but try applying to big hospitals that have a good reputation, there is a waiting list to even apply!

    I think that people in our world today don't think of nurses as professionals, especially when they portray us on T.V. like we are incompetent puppy dogs who follow and do everything the Dr. says. So I think as a profession we should unite and make it mandatory to require a B.S.N, just like other health professions. How does it make nurses look that we take anyone from Diploma to Doctorate degrees? (Not saying that one is better than the other, I just think there should be a set ENTRY LEVEL for Nurses.)

    Quote from ChristineN
    Yes, BSN grads have a more liberal arts education, but is that really going to help them on the floor right out of school?
    It makes a more well rounded person and nurse to have the extra liberal arts classes. And yes, you will use some of that knowledge on the floor. I remember taking Sociology of the Family, Child Psych and all different classes that related to people and society. These things are vital when taking care of different people and cultures.
  12. by   cardiacRN2006

    We have an entire fourm for this! Why, oh why does it constantly come up as a new thread?

    Do a search! Why do we need to go on and on and on and on about this?

    Quite frankly, it doesn't matter what other people think or feel. Currently, you DON'T need a BSN to practice. So there you go. Time for people to get over it and move on...
    Last edit by cardiacRN2006 on Apr 29, '08
  13. by   ChristineN
    Quote from Italia13

    It makes a more well rounded person and nurse to have the extra liberal arts classes. And yes, you will use some of that knowledge on the floor. I remember taking Sociology of the Family, Child Psych and all different classes that related to people and society. These things are vital when taking care of different people and cultures.
    Most nursing schools require a Growth and Development class, and my diploma program also required all students to take a diversity class. We also had a class devoted to leadership, another one devoted to nursing ethics/history, and another one on nursing communication (I list these as they are typically topics thought to be emphasized more in a BSN program).

    FYI: the Diploma vs BSN debate is something I am passionate about. Why? Because the small diploma RN program I attend has the 9th best NCLEX pass rate in the country, putting the surrounding BSN as well as ADN programs to shame. We also get more clinical experiences than at least the ADN students.

    I will be graduating in seven weeks and I feel ready and able to be a competent graduate nurse, something that is because of my diploma school education.
  14. by   TangoLima
    I too feel that nurses should have a BSN to practice. My main reasoning is for furthering nursing as a profession. Nurses are every bit as capable as physicians or any other healthcare worker, yet we are not viewed as a serious profession! If PT's require an MSN to practice, why do we require so much less of our nurses? The general public has no idea what nurses do or are capable of.

    Sure, BSN students may get a few less clinical hours during our degree program, but our clinical skills will improve quickly when we start practicing. Plus, BSNs have leadership, research, and communication skills that are an added bonus on the floor.

    Moreover, ADNs and BSNs need to stop resenting each other. ADNs are defensive that they are "only" ADNs (I don't mean for that to sound bad, just trying to make a point) and BSNs are defensive that we are BSNs, like we are supposed to feel bad that we went the BSN route. Let's start thinking about what's best for the furtherance of our profession and for the care of our patients.