A Different Approach to the ADN vs. BSN Debate

Nursing Students ADN/BSN

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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

Specializes in Medical/Oncology, Family Practice.

I have run into many people on the nursing units at the hospital (which has both ADN and BSN students and equally hires from both schools) who judge you based on your degree. I have had several nurses say to me and fellow BSN students "just because you are in a BSN program doesn't mean you know this or that" WHICH is TRUE! But, I don't like being talked down to just because I am working on my Bachelors so I can go on or do management. I do not appreciate being judged on my degree. I realize that this BSN program focuses less on clinical skill and more on critical thinking and problem solving, which will hopefully make us effective nurses in the long run. I don't want to be "better" than someone just because of my degree and knowlegde, I want to be judged on how I use it to care for my patients.

BTW--I have also had ADN students tell me that I would not get a job because I don't have the skills and because all we do is 'book work'. I have signed on and my nurse manager loves the fact I am a BSN student!

Specializes in NICU, PICU.

I just logged onto this site and I know I am entering this debate a bit late. I am a BSN working on my MSN/NP. After working in nursing at the bedside for several years now, I can truely say that I see little or no difference between the care provided by BSNs versus ADNs. I will also say that I really don't know what degree is held by most of my collegues. Individuals are judged based on the quality of care they provide and on their professionalism in practice. I really think the argument over who is a better nurse is just ridiculous.

Here is the kicker though...

If nursing is to define itself as a profession, which I don't believe it has to this point, a few things need to happen. Nursing must (and does) have a distinct body of knowledge. Nursing must have autonomy in practice and governance (which it doesn't have). Nursing must have a standard qualification for entry to practice.

If we as nurses want better pay, more respect in the healthcare community, and greater satisfaction in our work, it is imperative that we take control of our discipline (notice I did not say profession). Do I think it is important to have a standard for the level of entry into practice? YES! Do I think it will be a difficult transition? YES! Do I think it will be worth it? Emphatically, YES!!

Thanks for listening...reading...you know what I mean;)

Oh well ... I guess despite my efforts, this thread has turned into the same old debate.

Just as a reminder (especially before the thread gets shut down) ... the point of this thread was to discuss whether a BSN mandate would actually be practical and, also, in the best interests of nurses who already have their BSN. To wit:

* Where would the money come from to convert all of the ADN programs to BSN's?

* What would happen to ratios if a BSN mandate limited labor supply? Isn't it possible that patient loads would increase? Couldn't this thwart efforts in other states to pass ratio laws not to mention, make bedside nurses' lives more difficult?

* Why would BSN nurses want every nurse to get a BSN when it gives them a huge advantage and allows them to qualify for jobs that other ADN nurses don't qualify for?

:typing

I am a ADN RN. I started my nursing career as an LPN. I sat for the same exam as the BSN nurses. I hold an administrative position and am asked frequently to speak at different seminars all over the country. Most assume I have a Masters degree, I do correct them when they state this. My point is that just because someone does not have a BSN, you can not assume that they are not as intelligent or should not be put in a position other than bedside nurse. Each nurse should be judged on her/his abilities not on their degree. Requiring a BSN would severly limit the amount of students who would go into nursing.

Specializes in NICU.
With the BSN--how many years are actual nursing? Are the first two years prereqs and general courses and then 2 years of nursing?

The college I attended required 2 yrs liberal arts and 2 yrs of strictly nursing classes. The ADN programs combine general/liberal arts and nursing over a two year period, of course it likely takes longer than that but it is structured to be 4 semesters. I felt that I received a more balanced education than I would have in a 2yr program- and no, I am not saying this to cast doubt on the quality of the ADN programs.

Specializes in Critical Care.
The ADN programs combine general/liberal arts and nursing over a two year period, of course it likely takes longer than that but it is structured to be 4 semesters.

What ever gave you that idea?

~faith,

Timothy.

Specializes in NICU.
What ever gave you that idea?

~faith,

Timothy.

The 4 semester ADN program info is based on the community colleges in my area. The diploma programs are generally 3 yrs in duration.

Does this differ from your location?

The 4 semester ADN program info is based on the community colleges in my area. The diploma programs are generally 3 yrs in duration.

Does this differ from your location?

I'm not trying to step on Zasha's toes, but thought I'd offer up my school in this discussion: if you look at the flowchart, sure enough, you can finish an ASN in four semesters. However, what's NOT on there is the unwritten rule (that darn it ought to be written by now) that you'd better have everything that's a co-requisite course be done as a pre-requisite. So all the courses listed in the general curriculum "along with" the core nursing classes are expected to be taken before Fundamental Nursing. Many of these courses also have pre-reqs that take a year to complete (two semesters) and now with co-requs that have become pre-requs, add on another one to two semesters before your two years of actual nursing courses and clinicals.

How can they do this? Simply because the waiting list / demand has become so high that they can afford to limit admission to the nursing program to only those students who have already successfully passed everything else. While technically it's a four-semester program, if you haven't done all the general ed and electives for the Associates, you won't be high enough on the wait list to get a place come Fundamentals time. And administration makes no bones about it: the nursing classes alone will chew up all your time between skills lab, studying, clinicals, extracurricular assignments, research papers and community assignments (yep, we did them, too).

Specializes in NICU.
IMany of these courses also have pre-reqs that take a year to complete (two semesters) and now with co-requs that have become pre-requs, add on another one to two semesters before your two years of actual nursing courses and clinicals.

.

Ah yes- the prereqs...

Gotta love it :madface: I took 6 yrs to finish my BSN because of all the "extras" involved. Regardless of where you obtain your nursing degree, it is going to be one of the hardest things you will be involved in. But worth it regardless! :wink2:

Specializes in NICU.
Oh well ... I guess despite my efforts, this thread has turned into the same old debate.

Just as a reminder (especially before the thread gets shut down) ... the point of this thread was to discuss whether a BSN mandate would actually be practical and, also, in the best interests of nurses who already have their BSN. To wit:

* Where would the money come from to convert all of the ADN programs to BSN's?

* What would happen to ratios if a BSN mandate limited labor supply? Isn't it possible that patient loads would increase? Couldn't this thwart efforts in other states to pass ratio laws not to mention, make bedside nurses' lives more difficult?

* Why would BSN nurses want every nurse to get a BSN when it gives them a huge advantage and allows them to qualify for jobs that other ADN nurses don't qualify for?

:typing

Dang-it! Well, at least you tried Lizz.

I think you have a very valid point. Where I live in Southeast Colorado, there are two ADN programs and zero BSN programs. Therefore, if someone wants to become a BSN prepared nurse, they have to travel to Pueblo (over two hours away), leave their area and community, and thus take greatly needed healthcare away from this community. In the town in which I work, only one nurse that I know of has a BSN, even the charge nurse here has an ADN because the demand is so great and most of the BSN nurses move to the cities where they can advance further. To live out here, you have to be in it for the love of the community and it's people, not the money. Typically, the people that work here have lived here all their lives, went to school at one of the CCs that they either had to drive 36 miles to attend or 72 miles to attend (one way).

I cannot even begin to imagine what would happen if those schools no longer offered the ADN program (I am 100% sure they could not transition to the BSN program, they are, after-all, low-funded community colleges). I fear that, if that happened, our local hospital would cease to exist or would have to be run purely by agency nurses. If all of the Bachelor's degree nurses were more expensive for this hospital to obtain, it could no longer stay afloat (it is struggling as it is), and it would shut it's doors. What a shame - and all because there is an ongoing argument among nurses of "who is better". So sad.

I personally am attending an ADN program and drive 50 miles (I live 21 miles from the town I was referring to) one way to attend night/weekend classes because I have a family and have to work full-time, and I have to get student loans to pay for my education. Between the cost of driving to Pueblo and the higher tuition rates as well as the time it would take away from my work and my family, that would make going the BSN route impossible for me at this stage in my life. I am but a lowely student, but I think I am going to turn out to be a very caring and compassionate nurse and it would be too bad if those doors were closed to me.

Great point Lizz - thanks!

I'm not saying this applies to all ADNs, as some are very intelligent,
Well, how very generous of you to concede that at least *some* of us are intelligent. What percentage of us, do you suppose, are intelligent? And What percentage would then remain who are *not* intelligent? More than half? Please, do not make an a$$ of yourself by assuming that I chose an ADN program over a BSN program because I was not as intelligent as most BSN students. I would compare my wits and intelligence against those of the student body of any BSN program of your choosing. I guarantee you I would be in the top 10%, and I would very likely make it into the top 3% or better.

but across the board, I believe an RN has too many responsibilities to suffice with a possible two year degree at a community college.

An education is what you make of it. I, for instance, managed to learn proper grammar without the benefit of a BS in anything. As a matter of fact, I was an accomplished writer and speaker of the English language before I even attended a community college!

This is why we see disgruntlement from colleagues of mine from college who became PTs, LCSWs, and MDs, who see some of us that don't even have BS degrees, much less a masters that practice the level of medicine we do.

I would be pretty upset to see you practicing medicine as well! I, for one, do not even attempt to practice medicine. We are not trained to practice medicine. We are trained to practice nursing. They are not the same. Perhaps it is your confusion over the matter that scares your colleagues, not the fact that some of us have ADNs.

I don't believe there will be any effect except a more evenly educated and qualified RN in hospitals who is more highly respected in the medical community.

If only the BSN programs also created nurses with a stronger grasp of the English language. But alas, as demonstrated here, they do not.

Responsibilities will simply be reallocated between LPN/LVNs and RNs. Saying that this will force all RNs to eventually be required to get MSNs is rediculous.

It would be ridiculous! Fortunately, that is not what the OP said. She said that if all RNs had to have a BSN, then only those positions that currently require a BSN or higher would then begin to require a minimum of a Master's. She did not say that all nurses would need to get MSNs. Clearly, your BSN preparation also did not prepare you for higher-level reading comprehension.

That is like claiming that all RTs eventually have to up there education. Not true, because they don't have the problem with grey areas like we do.

You did mean "up *their* education" didn't you? In any case, I will not even attempt to debate you on this, as I am not an RT and am not qualified to say how grey the issues they deal with may or may not be. And just a guess, but I would imagine that, in addition to failing to teach you basic grammar and reading comprehension skills, your BSN program may also have neglected to train you as a fully qualified RT as well!

Specializes in Home Health Care.
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