A Different Approach to the ADN vs. BSN Debate

[Sheri257]

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

[ZASHAGALKA, RN]

As soon as BSN became standard across the profession, those differentiations that now benefit BSN would move up the chain to MSN.

BSNs that now hold those jobs would be told that they either need to 'upgrade' to MSN, or go back to being a bedside nurse, because BSN only qualifies you to be a bedside nurse.

~faith,

Timothy.

[Sheri257]

As soon as BSN became standard across the profession, those differentiations that now benefit BSN would move up the chain to MSN.

BSNs that now hold those jobs would be told that they either need to 'upgrade' to MSN, or go back to being a bedside nurse, because BSN only qualifies you to be a bedside nurse.

~faith,

Timothy.

Well ... that's my point. A BSN mandate could actually turn out to be a huge disadvantage for BSN nurses who now stand out and qualify for positions that most nurses don't qualify for.

:typing

[FullTimeTraveler]

I disagree completely. There is already a distinction between LVN/LPNs, RNs, and NPs, all with there own teir of responsibilities. The problem is, there is a division among RNs b/c of the ADN vs BSN, and honestly, there is a difference. I meet individuals in this profession everyday that you can clearly see a difference in education levels. I'm not saying this applies to all ADNs, as some are very intelligent, but across the board, I believe an RN has too many responsibilities to suffice with a possible two year degree at 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. We need every level of the hospital staff, from CNAs MAs, to midlevels, to MDs. 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. 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. 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.

[S.N. Visit, BSN, RN]

I meet individuals in this profession everyday that you can clearly see a difference in education levels. I'm not saying this applies to all ADNs, as some are very intelligent, but across the board, I believe an RN has too many responsibilities to suffice with a possible two year degree at a community college. 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. .

Are you saying that an ADN isn't qualified enough to be a RN'? Please elaborate...I'm now sarcastically stating in my most Beverly Hillbilly voice, "I gots only a 2 yr college education to learns me how to be a nurse!"

[FullTimeTraveler]

I said "across the board" (on average). Every facet of society benefits from more education. Why should something as important as nursing be any different?

[suzy253, RN]

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

[S.N. Visit, BSN, RN]

I said "across the board" (on average). Every facet of society benefits from more education. Why should something as important as nursing be any different?

According to our State boards of Nursing , they seem to think ADN's are efficient enough to work in the RN scope of practice. I see no reason to not further education. I am personally going on for my BSN however, I see no reason to disrespect/down grade/ act superior to ADN's either. ADN programs are not cake walks. They consist on average, 3 yrs in length. We aren't sitting around playing tick-tac toe and learning 5th grade math. We are apparently intelligent enough to pass the same NCLEX that the BSN graduate takes. What are BSN students learning in class about ADN programs? I see a lot of supremists attitudes on this board.

If you are talking about staff /floor nurses, I see great fault with your statement that you can clearly see the intelligence difference between ADN & BSN prepared nurses. What a terrible insult to insinuate!

[Sheri257]

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.

Even if you assume that BSN grads are better nurses ...

I don't see how you can say there won't be any effect with a BSN mandate. It looks from your user name and profile that you're a traveler working in California.

70 percent of the nursing programs in this state are ADN programs. Overall, the schools produce 6,000 new grads a year and more than 4,000 of those nurses are ADN grads.

Where is the state going to get the money to convert all of these programs to BSN's? My CC doesn't have any money to do that and I seriously doubt that the other schools have that kind of money either.

And, even if the state did have the money ... what happens to staffing ratios if you delay the graduation date for 4,000 new grads while ratios for med-surg, etc. are supposed to go down from 5:1 to 4:1 next year?

Aren't staffing ratios just as important to patient safety and quality of care? Or, is it better to have "more educated and qualified" BSN nurses with heavier patient loads. Isn't it possible that patient care would suffer just as much, if not more?

If you create some bottleneck where you severely limit the supply of nurses ... this would give the hospitals the perfect excuse to go back to court and tell the judge that ratios are damn near impossible to meet.

I wish the BSN proponents would be more practical and discuss how this is supposed to work in the real world because, in a lot of ways, it doesn't.

:typing

[MSADN, ADN]

Most of my ADN classmates already had a four year degree in another field before they came to nursing. I think as many as 10 had Masters level degrees. That's pretty well educated I'd say. A 19 y/o nursing student just out of high school is a huge exception in my school.

Oh, I'm the least formally educated person in my class. But I can read, write, and communicate as well or better than most. You can receive a liberal arts background with autodidactism if you have a normal curiosity and an inability to remain ignorant.

[jjjoy, LPN]

I agree with the concept of improving working conditions taking priority over increasing educational requirements as a means to better the profession. Pragmatically, switching to all BSN-entry is much more difficult to swing than demanding (somehow) that hospitals hire more nurses and staff their units better. Less nurses would be running away from nursing if they felt they weren't risking their license every day or providing less than quality care.

[Jami_Jared]

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 bachelors program that I attended had 3 years of primary nursing classes and 1 year of prereqs and general courses. But our college went above and beyond the minimal standards requiring 480 hours of clinicals a year, which frustrated me at first, because it seemed like we didn't have time for anything but school. But in the end it was all to make us a better nurse. I hope that you weren't intending to downplay a bachelor's degree by asking how many years are actual nursing?? Because the prereqs also included a baseline of developmental psych, death & dying classes, science, math, english, statistics, research, and many others that want to lead to a well rounded Bio/Psycho/Social degree. I just feel that we shouldn't have to defend our higher levels of education. Why are people so critical ...is it jealously? Or is it that people want to have more for less work, less time, less effort? It really isn't fair overall. We should want to hold bachelor's degree. We all should want to be overachiever's so that we can put our best foot forward and give our patients the best care possible.