Do I REALLY need a BSN?

Guest343211 · Sep 18, 2012

*** Actually that's not the case at all. There is nothing about obtaining Magnet that requires staff RNs, or a percentage of staff RNs to hold BSNs. There IS a requirment that nurse leaders, managers, CNO's have degrees in nursing.

Yes, there is. It is not "required," for RN staff, per se, but it is STRONGLY DESIRED. What is strongly desired is part of the market demand--and they can do it; b/c it's a buyer's market. They have limited hiring right now.

See:

American Association of Colleges of Nursing | The Impact of Education on Nursing Practice

Read between the lines.

And it's doable now for them, b/c of limited hiring, the selling point of Magnet status, etc.

[h=4][Recognizing Differences Among Nursing Program Graduates[/h]

There is a growing body of evidence that shows that BSN graduates bring

unique skills to their work as nursing clinicians and play an important role in

the delivery of safe patient care.] - AACN (noted above)

...continued:

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[in a study published in the March/April 2005 issue of Nursing Research, Dr. Carole Estabrooks and her colleagues at the University of Alberta found that baccalaureate prepared nurses have a positive impact on mortality rates following an examination of more than 18,000 patient outcomes at 49 Canadian hospitals. This study, titled The Impact of Hospital Nursing Characteristics on 30-Day Mortality, confirms the findings from Dr. Linda Aiken’s landmark study in September 2003.

In a study published in the September 24, 2003 issue of the Journal of the American Medical Association (JAMA), Dr. Linda Aiken and her colleagues at the University of Pennsylvania identified a clear link between higher levels of nursing education and better patient outcomes. This extensive study found that surgical patients have a "substantial survival advantage" if treated in hospitals with higher proportions of nurses educated at the baccalaureate or higher degree level. In hospitals, a 10 percent increase in the proportion of nurses holding BSN degrees decreased the risk of patient death and failure to rescue by 5 percent. The study authors further recommend that public financing of nursing education should aim at shaping a workforce best prepared to meet the needs of the population. They also call for renewed support and incentives from nurse employers to encourage registered nurses to pursue education at the baccalaureate and higher degree levels.

Evidence shows that nursing education level is a factor in patient safety and quality of care. As cited in the report When Care Becomes a Burden released by the Milbank Memorial Fund in 2001, two separate studies conducted in 1996 – one by the state of New York and one by the state of Texas – clearly show that significantly higher levels of medication errors and procedural violations are committed by nurses prepared at the associate degree and diploma levels as compared with the baccalaureate level. These findings are consistent with findings published in the July/August 2002 issue of Nurse Educator magazine that references studies conducted in Arizona, Colorado, Louisiana, Ohio and Tennessee that also found that nurses prepared at the associate degree and diploma levels make the majority of practice-related violations.

Chief nurse officers (CNO) in university hospitals prefer to hire nurses who have baccalaureate degrees, and nurse administrators recognize distinct differences in competencies based on education. In a 2001 survey published in the Journal of Nursing Administration, 72% of these directors identified differences in practice between BSN-prepared nurses and those who have an associate degree or hospital diploma, citing stronger critical thinking and leadership skills.

Studies have also found that nurses prepared at the baccalaureate level have stronger communication and problem solving skills (Johnson, 1988) and a higher proficiency in their ability to make nursing diagnoses and evaluate nursing interventions (Giger & Davidhizar, 1990).

Research shows that RNs prepared at the associate degree and diploma levels develop stronger professional-level skills after completing a BSN program. In a study of RN-to-BSN graduates from 1995 to 1998 (Phillips, et al., 2002), these students demonstrated higher competency in nursing practice, communication, leadership, professional integration, and research/evaluation.

Data show that health care facilities with higher percentages of BSN nurses enjoy better patient outcomes and significantly lower mortality rates. Magnet hospitals are model patient care facilities that typically employ a higher proportion of baccalaureate prepared nurses, 59% BSN as compared to 34% BSN at other hospitals (emphasis mine). In several research studies, Marlene Kramer, Linda Aiken and others have found a strong relationship between organizational characteristics and patient outcomes.

The fact that passing rates for the NCLEX-RN©, the national licensing exam for RNs, are essentially the same for all three types of graduates is not proof that there are no differences among graduates. The NCLEX-RN© is a multiple-choice test that measures the minimum technical competency for safe entry into basic nursing practice. Passing rates should be high across all programs preparing new nurses. This exam does not test for differences between graduates of different entry-level programs. The NCLEX-RN© is only one indicator of competency, and it does not measure performance over time or test for all of the knowledge and skills developed through a BSN program.

There is absolutely no question that hospitals with Magnet Recognition prefer to hire nurses with a BSN. Look at national trends and all the hospitals that have or are in hot pursuit of Magnet.

PMFB-RN, RN · Sep 18, 2012

Yes, there is. It is not "required," for RN staff, per se, but it is STRONGLY DESIRED. What is strongly desired is part of the market demand--and they can do it; b/c it's a buyer's market. They have limited hiring right now.

*** Naturaly. However, having sat on two hospital's Magent committee during their "Journy to Magnet" I know there is not such requirment for staff RNs to have degrees.

And it's doable now for them, b/c of limited hiring, the selling point of Magnet status, etc.

*** Magnet hospital are fast gaining a reputation as not being good places for nurses to work. The may be shooting themselves in the foot here.

[h=4][Recognizing Differences Among Nursing Program Graduates[/h]

There is a growing body of evidence that shows that BSN graduates bring

unique skills to their work as nursing clinicians and play an important role in

the delivery of safe patient care.] - AACN (noted above)

*** Sorry don't see the relivance to the discussion.

There is absolutely no question that hospitals with Magnet Recognition prefer to hire nurses with a BSN. Look at national trends and all the hospitals that have or are in hot pursuit of Magnet.

*** With some exceptions I would agree. However the preference to hire only nurses with a BSN is not a result of seeking Magnet status, rather both seeking Magnet and BSN only hiring are indicators of the mentaliety of the nurse administrators of that hospital.

Music in My Heart · Sep 18, 2012

For many hospitals, it's simply another means to winnow down the applicant pool to more manageable numbers... simple as that.

If you want to maximize your chances of being hired, a BSN is probably a good idea.

Guest343211 · Sep 18, 2012

*** Naturaly. However, having sat on two hospital's Magent committee during their "Journy to Magnet" I know there is not such requirment for staff RNs to have degrees. And it's doable now for them, b/c of limited hiring, the selling point of Magnet status, etc.*** Magnet hospital are fast gaining a reputation as not being good places for nurses to work. The may be shooting themselves in the foot here.[h=4][Recognizing Differences Among Nursing Program Graduates[/h]There is a growing body of evidence that shows that BSN graduates bringunique skills to their work as nursing clinicians and play an important role in the delivery of safe patient care.] - AACN (noted above)*** Sorry don't see the relivance to the discussion.The relevance is that those highly influential in nursing politics and leadership are pushing the points to meet the agenda. Having Magnet is a selling point as are those data, which Nursing organizations are using to "move nursing forward."They may be shooting themselves in the foot, but they aren't going to move off this path until something in the market changes. They are going to get the most mileage out of the current economic situation as they can. There are powers that be that want to see a workforce of at least 1/3 doctoral prepared.There is absolutely no question that hospitals with Magnet Recognition prefer to hire nurses with a BSN. Look at national trends and all the hospitals that have or are in hot pursuit of Magnet.*** With some exceptions I would agree. However the preference to hire only nurses with a BSN is not a result of seeking Magnet status, rather both seeking Magnet and BSN only hiring are indicators of the mentaliety of the nurse administrators of that hospital.

Don't miss the overall point bc of some phrased wording in some meetings. Just bc it's not handed down like the commandments at Sinai doesn't mean that the agenda is any less true.Bottom line is, yes, if you want to get a nursing job, get the BSN. We're not looking at statistical outliers here.

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allnurses Guide · Sep 18, 2012

Having extra letters after your name does not make you a better nurse.

Having extra letters after my name doesn't make me a better nurse than you, question is would having extra letters after your name make you a better nurse?

kcmylorn · Sep 18, 2012

I personally want to see an article being very specific on how BSN's are better than ADN or diploma nurses and how a BSN- give me examples of these "unique professional skills" that they feel BSN's do better than ADN's and diploma nurses!! not some vague ambigiuous generalization" unique professional skills" do nurses do cart wheels down the halls with out falling on their butts with a BSN. What are these "unique professional skills" taking a rectal temp long distance or by remote control??

I can't tell you haw many patients I have had that are interested in nursing research or EBP and how to research for EBP. (LOL)

What I have seen is BSN nurses being treated differently( more listened to, given more respect, less likely to have the dirty underhanded tricks of managment played on them, less of nursing managment wanting to destroy their careers and professional crediability, less fought with, more scheduling favors, definately more hiring/no secret there Nursing profession) than their diploma and ADN counterparts by their nursing managers- that's not a special talent or a "unique professional skill"- that's discrimination in the workplace. I guess nursing managment think we diploma and ADN's are too stupid and uneducated to see it or notice. I don't think anyone can deny it doesn't exist.

Perhaps it's just little old diploma me- but I expect these nurses with their degrees to behave in a manner that reflects a college education but I'm not seeing that.

My favorite is - when you ask a degreed nurse, BSN or MSN, on the unit a question and get the look/sizing you up and down and walk away with out an answer to the question. I wouldn't exactly call that behavior worthy of a college education. maybe someone who has just spent a hard night on the street. That behavior came from a MSN-NP/ Pulmonary NP!!

Guest343211 · Sep 19, 2012

I personally want to see an article being very specific on how BSN's are better than ADN or diploma nurses and how a BSN- give me examples of these "unique professional skills" that they feel BSN's do better than ADN's and diploma nurses!! not some vague ambigiuous generalization" unique professional skills" do nurses do cart wheels down the halls with out falling on their butts with a BSN. What are these "unique professional skills" taking a rectal temp long distance or by remote control??
I can't tell you haw many patients I have had that are interested in nursing research or EBP and how to research for EBP. (LOL)

I posted this previously. It's from the AACN (The Impact of Education on Nursing Practice).

I am not saying I totally agree with the leaps that have come from the referenced research. Again, I do think they took a lot of license with Aiken's and the work of others. Regardless, they are taking it and running with it.

Now, I do believe that we all benefit from more education; but I define education a little differently from others. You really have to assess and evaluate individuals. When I was young 20 something I got an ADN in nursing. The program had its ups and downs, and frankly was a real pain in the butt at times. I took the NCLEX back in the days when they actually gave you a score. I got a job in a highly regarded medical center b/c I didn't have my license yet--the state was backed-up in issuing the license--so they gave you a little piece of paper that said, "Congratulations, you're a Registered Nurse--and here is your score." When I interviewed, b/c I didn't have my license yet, I had to take that piece of paper with me. Well, when the nurse recruiter saw my NCLEX score--which is calculated differently today, she and the NM were like, "You got the job."

Even then, you have to work and get experience and learn how to fuse all the information in terms of real life applications. That takes time and experience. No one gets the kind of clinical experiences many of the diploma nurse programs used to give to their students. ADN programs may be a little bit better clinically, b/c they throw you right into it immediately--it all moves fast. But the clinical experience just isn't what it used to be for any program anymore.

On top of that, regardless of one's degree, it's up to the individual nurse to continue to learn. I remember going home with homework from work--some required, and some of interest to me, b/c I would be caring for various kinds of patients--I took it upon myself to get information and learn. Now this wasn't as easy back then before the Internet--or the relative ease with which one can now access databases through universities, etc.

I mean I hear what you are saying, but there is information that suggests that more education builds a community of more safety-based individuals. Like I said, I think they are stretching that, b/c while I love and value didactic learning, you just HAVE to put it together with clinical applications in order to be both safe and efficacious. I definitely do not necessarily agree with regard to the conclusions on critical thinking skills. I would definitely need to look at more research on that. Also, we have to evaluate the cultural and generational influences on critical thinking skills. We can look at delayed adult maturation as a factor in more current decades contrasted with previous ones. There are many other factors as well.

But as someone said in another thread, "Don't hate the players, hate the game." Something like that.

The political nursing powers that be are running with this b/c they can. Still, increasing education can't be a bad thing--unless people are just getting grades but aren't really getting anything out of their education, other than a piece of paper and letters. Sadly that does happen enough, but you know that happens in all fields. That's why I only give the terminal degree so much weight necessarily. I know tons of people that are truly educated and don't have a lot of letters or degrees to validate them, while I also know a lot of formerly educated people that do not demonstrate the insight, critical thinking, or even knowledge base in their fields as others that may not have the same terminal degree. It's only when you work and talk with people that you can get a genuine feel for this--or when you give them batteries of objective tests along with working with them. As you relate with them, you read their insights, and you realize that some people really love to learn--whether they have the carrot (degree) or not. And then there are those that have some sort of carrot, but they really are what I considered truly educated people--in that they aren't interested in continually learning--with or without some sort of carrot. I call those that love to learn innately educated or driven toward learning. For them not to learn is like taking away oxygen.

Really political issue has come down to drawing a line in the sand about baseline education for nurses. It truly is nursing politics issues. (There also some financial factors, but that's a different thread.)

Of course having an undergraduate or graduate level degree doesn't necessarily make a person more professional or educated or effective. Where a nurse or person in any field is professional, truly educated, and effective in their role is totally an individual thing.

I think the nursing uppercrust, so to speak hopes that for most people, obtaining the baseline 4 year education may lead to better effectiveness; mostly, however, it's a means of nursing trying to establish itself as a credible profession. Since most other professions require a baseline bachelor's degree, nursing powers and politicals feel that nursing must also.

As I said somewhere else, I believe what they are aiming for is to make it to be a clinical nursing workforce that is 1/3 BSNs, 1/3 MSNs, and 1/3 DNS or the like.

There is nothing new about a goal such as this. It's been desired for many decades now. Right now, they can push it b/c of the current market/economy. So they are going for it.

At any rate, this is a summary of some of the research of which you inquired:

[in a study published in the March/April 2005issue of Nursing Research, Dr. Carole Estabrooks and her colleagues atthe University of Alberta found that baccalaureate prepared nurses have apositive impact on mortality rates following an examination of more than 18,000patient outcomes at 49 Canadian hospitals. This study, titled[COLOR=#003366] The Impact of Hospital Nursing Characteristics on 30-DayMortality, confirms the findings from Dr. Linda Aiken’s landmark study inSeptember 2003.

In a study published in the September 24, 2003issue of the [COLOR=#003366]Journal ofthe American Medical Association (JAMA), Dr. Linda Aiken and hercolleagues at the University of Pennsylvania identified a clear link betweenhigher levels of nursing education and better patient outcomes. This extensivestudy found that surgical patients have a "substantial survivaladvantage" if treated in hospitals with higher proportions of nurseseducated at the baccalaureate or higher degree level. In hospitals, a 10percent increase in the proportion of nurses holding BSN degrees decreased therisk of patient death and failure to rescue by 5 percent. The study authorsfurther recommend that public financing of nursing education should aim atshaping a workforce best prepared to meet the needs of the population. Theyalso call for renewed support and incentives from nurse employers to encourageregistered nurses to pursue education at the baccalaureate and higher degreelevels.

Evidence shows that nursing education level is afactor in patient safety and quality of care. As cited in the report [COLOR=#003366]WhenCare Becomes a Burden released by the [COLOR=#003366]Milbank Memorial Fund in 2001, two separate studiesconducted in 1996 – one by the state of New York and one by the state of Texas– clearly show that significantly higher levels of medication errors andprocedural violations are committed by nurses prepared at the associate degreeand diploma levels as compared with the baccalaureate level. These findings areconsistent with findings published in the July/August 2002 issue of [COLOR=#003366]Nurse Educator magazine that references studiesconducted in Arizona, Colorado, Louisiana, Ohio and Tennessee that also foundthat nurses prepared at the associate degree and diploma levels make themajority of practice-related violations.

Chief nurse officers (CNO) in universityhospitals prefer to hire nurses who have baccalaureate degrees, and nurse administratorsrecognize distinct differences in competencies based on education. In a 2001survey published in the [COLOR=#003366]Journalof Nursing Administration, 72% of these directors identifieddifferences in practice between BSN-prepared nurses and those who have anassociate degree or hospital diploma, citing stronger critical thinking andleadership skills.

Studies have also found that nurses prepared at the baccalaureate level havestronger communication and problem solving skills (Johnson, 1988) and a higherproficiency in their ability to make nursing diagnoses and evaluate nursinginterventions (Giger & Davidhizar, 1990).

Research shows that RNs prepared at theassociate degree and diploma levels develop stronger professional-level skillsafter completing a BSN program. In a study of RN-to-BSN graduates from 1995 to1998 (Phillips, et al., 2002), these students demonstrated higher competency innursing practice, communication, leadership, professional integration, andresearch/evaluation.

Data showthat health care facilities with higher percentages of BSN nurses enjoy betterpatient outcomes and significantly lower mortality rates. [COLOR=#003366]Magnethospitals are model patient care facilities that typically employ ahigher proportion of baccalaureate prepared nurses, 59% BSN as compared to 34%BSN at other hospitals (emphasis mine). In several research studies,Marlene Kramer, Linda Aiken and others have found a strong relationship betweenorganizational characteristics and patient outcomes.

The fact that passing rates for the NCLEX-RN©, the national licensing exam forRNs, are essentially the same for all three types of graduates is not proofthat there are no differences among graduates. The NCLEX-RN© is amultiple-choice test that measures the minimum technical competency forsafe entry into basic nursing practice. Passing rates should be highacross all programs preparing new nurses. This exam does not test fordifferences between graduates of different entry-level programs. The NCLEX-RN©is only one indicator of competency, and it does not measure performance overtime or test for all of the knowledge and skills developed through a BSNprogram.

[COLOR=#003366]American Association of Colleges of Nursing | The Impact of Education on Nursing Practice

American Association of Colleges of Nursing | The Impact of Education on Nursing Practice

kcmylorn · Sep 19, 2012

I know Linda Akien's school of nursing is a very expensive one- private and Ivy league, Univ of Penn.. I had been a traveler in Linda Akiens' Hospital affiliate- HUP for 1 year. I was not impressed with the skill level of nurse that program or any of the BSN programs in that city produced- that was back in 2005-2006. I had been an RN at that point for 20+ years and still with only a diploma. What i saw was alot of desk sitting and the CNA's doing all the physical hands on. The information I would recieve in report was very mediocre to say the least. They could tell tales of their nursing school adventures to Denmark or Sweden and practiums in global health. Their other courses were way out there also. it was clear- these nursing school graduates were not being educated to work any hospital Sorry, but that's my opinnion from my own observation.

The nurses I did find impressive were Thomas Jefferson grads- they had the hands on skill of a diploma nurses and gave very informative shift change reports- as a nurse following them on the next shift, the patient's were as they said they were.

My biggest beef with this BSN thing is - forcing it down the throats of nurses who cannot afford it in this economy and locking said nurses out of jobs to earn a living to afford that BSN. (Isn't earning a living- a pay check, credit potential, loan /money borrowing power for those student loans to spend on tuition?) I have found over the past 30 years of nursing- this kind of illogical thinking is tipical of the nursing profession. So I therefor place very little creedance in any thing nursing academia reports on. To me, it all seems very vulgar and crass in an economy with an unemployment rate of 8.3 % and yes, academia- alot of that percentile are nurses- so what are YOU going to do about it. All this BSN hype and extortion is to keep nursing academia employed.

I would love to write a letter to Dr Beurhaus@ Vanderbilt Univ( another high priced hall of academia)- and ask him when the last time he took a walk down one of our country's city streets with his eyes open, or a field trip to the unemployment office or filled out a job application for a common acute care bedside nursing position and leave off all the letters from behind his name except RN. Ask him to be a real common folk RN. To interview some of us common folk worker bees to see what it is really like in these trenches. Not something from a statistcs or nursing theory text. Does he even attend some of these protests and rallies of the NNU or any other nursing strike? and talk with some of the staff nurses there?to find out what their issues and concerns are first hand? i don't think it would be a good idea to go in a suit and tie.

kcmylorn · Sep 19, 2012

This whole BSN push at this time in the economy - really saddens me. It is such an oximoron. With thinking and bandwagon soapboxes like this- nursing will never add credibility to the profession. I can understand targeting the already degreed and "working" experienced nurse for the APN-NP's but not the RN's and LPN's who are just barely making ends meet on partime, agency, per diem and temp position work and/or unemployment to foot the bill of this expensive endeavor. And locking them out of gainful employment so they will never economically recover. This is just plain wrong on so many levels.

There is no economic turnaround with this mentality!! It doesn't take a MBA to figure that out.

redhead_NURSE98!, ADN, BSN · Sep 19, 2012

Well I know *I* would rather have a floor full of brand new grad 23 year old BSN nurses taking care of me over 15 year veteran ASN's and LPN's...how bout you? :rolleyes:

allnurses Guide · Sep 19, 2012

There is no reputable study that proves patient outcomes are better due to whether or not one holds an ADN degree or a BSN degree at the time the question is asked. There are quite a few "associated with" articles, lots of "surveys", etc. The question is simplistic and becoming more so as people get their BSNs in a variety of ways with a wide range of prior experience (a factor not included in Linda Aiken's 2003 study of post-op surgical patients btw) to take a BSN who was an and ADN for 20 years first and compare it with one who just graduated.

I don't understand why people think the AACN is objective, either. They bend over backwards to discredit any research findings that don't fit with their talking points. One could only wish they brought such energy to scrutinizing the studies they claim prove the better outcome point.

Wet Noodle · Sep 19, 2012

What would happen if all the diploma and ADN nurses were to suddenly disappear, leaving behind only the BSN and APRN nurses?

There is no reputable study that proves patient outcomes are better due to whether or not one holds an ADN degree or a BSN degree at the time the question is asked. There are quite a few "associated with" articles, lots of "surveys", etc. The question is simplistic and becoming more so as people get their BSNs in a variety of ways with a wide range of prior experience (a factor not included in Linda Aiken's 2003 study of post-op surgical patients btw) to take a BSN who was an and ADN for 20 years first and compare it with one who just graduated.

As far as I know, that is correct. The famous BSN-correlated-with-lower-mortality study has been widely criticized.

The hypothesis, I suppose, is that BSN nurses are better equipped for critical thinking than are ADN or diploma nurses (perhaps because of the extra nursing theory course taken? (Kidding.) More clinical time? Being two or so years older before practicing? It's not clear at all. The research in the area is very weak.

It's pretty clear that an ADN nurse with 20 years experience is on the average far more capable than a new grad BSN nurse (or advance practice nurse with little clinical work experience).