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 Home Health Care.

I guess I'll have to settle being a "lazy ADN nurse", as well. And to think this whole time I thought it was far more intelligent for me to pay $91 a credit at the cc. vs the $292 per credit for BSN. (Then complete the on-line RN-BSN.) I also thought to attend my home town's CC verses driving 2hrs away to the closest university away from my husband and 3 children. hmmm...... when did priorities become lazy?

If entry level BSN were to be mandated in Iowa, we would loose many potential nurses. Like I said the closest BSN program to me is appx. 2 hrs away. We just don't have the schools here. Our state is not a rich state . Where would the funding come from?

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

I find the "laziness" application to ADN's saying they feel they are "as good" as BSN nurses, quite an affront. But that is just me and like Tweety, I can deal with that. I will just say, for the 60% of first-time RNs across the country that enter nursing with an ADN degree, this surely is not true. AD programs quickly weed out the lazy ones by attrition. Those who graduate don't get there by being lazy, but pure hard work and dedication. AD programs are notoriously difficult and are NOT 2 year degrees, even if they are called such. I know of nobody who achieved an AD in nursing in 2 years. Not one.

I do find it important for EVERY nurse to continue his/her education throughout their career. This education should not necessarily be BSN, however, in my eyes. Certification is one way. Achieving degrees in related programs of study, should be another. There are many ways to upgrade the level of education in nursing---we ought think outside the box when considering this. I would not mind seeing ALL Nurses have baccalaurate-level education, but if they have diplomas or ADN, then another program of study would be nice. It would enhance the diversity of knowledge nurses possess, and to me, would be an excellent improvement and strength for us all. If you ask me, to assist us to take a place at the administrative table, let's get more business and economics-educated nurses in our ranks! Or better yet, incorporate negotiation skills/education, business and economics into EVERY nursing program, nationwide. Let's prepare nurses to be LEADERS in health care----to do this, we need to know a lot more about how businesses are run, and the economics of such---and be better negotiators on behalf of ourselves!

Also a fact for those who think ADN nurses are lazy or lack ambition: BSN programs are also quite hard to access for generic, first-time nurses. There are, to my knowledge, not any programs that are strictly online access. You still have to get to a brick-and-mortar institution to attend classes. Clinicals sites/locations are still a huge consideration. Extensive travel for either can be impossible for students who live many miles from the nearest university (let alone one that has a nursing program/college of study)-----and also tough for those who study nursing that have families to support while they do so. I could not drive 170 miles each and every day to study nursing in a BSN program.; I had a family and husband who was military and gone for a lot of the time I was in school. There were 4 AD programs much nearer and accessible to me--so the choice was obvious in my case.

Also, because so many are returning adult students, costs are a major factor. Like it or not, community colleges are a better deal, period. Much more affordable and that associate's degree WILL get you a decent return on any investment made. Not everyone qualifies for aid or scholarships, so those who don't have to consider how to pay for school, especially tough if you have kids to feed and clothe. Laziness is not even a factor for these folks, clearly. How easy can it be to go to school, work AND raise a family?

What would make me lazy is to refuse to continue to improve my education and stay current, which I do. Because I have no real desire to study for a BSN, this does not make me lazy, either. It does make me discerning as to how I spend the time I have. That is my take on this, anyhow.

I respect *all* nurses, because I know every one of us endured a LOT to get here, and we continue to endure much to remain nurses in today's difficult environments. I wish we could all respect each other, regardless of level of education or specialty. I find it so interesting how we continue to find ways to insult each other---I guess, to make ourselves feel better. Nurses find all kinds of divides, from speciality, to level of education, to even work status (perdiem versus fulltime, for instance, or nightshift versus dayshift). Having an all-BSN entry requirement won't cure such ills. We have to stop being the proverbial "crabs in the bucket" and get over looking for division among us already.

And to those of you continuing on to BSN or MSN or higher degrees, I respectfully tip my hat. Enough from me, I suppose..............

Specializes in Pulmonology/Critical Care, Internal Med.

Speaking of funding, part of the problem comes from the University its self, and part comes from either tuition costs being so low or the way the state manages the university. I go to a Land Grant institution here in Alabama. Part of the job of the Land Grant universities is to provide graduates that can help fill the positions that the state needs. Frankly, the state doesn't need any more sociology majors, but does need a lot of nurses. I think alot of times the university focus's on what brings them in money, such as the Vet School, the Pharmacy school, the engineering school, and they often forget about schools such as Nursing that have to turn away wonderful candidates soley because they don't have the money to hire more professors. This money is controlled by the University, they decide their budget for the various colleges. I can tell ya, being on the faculty committee of my Nursing School, I get to see alot of how all the politics really work.

I think what you have to have is the following. The powers that be want to make the DNP the entry level to advanced practice, well before we can make that huge leap we need to decide what is the entry level into Professional Nursing. The BSN should be the entry level. Just like with the proposed law in NY, you should have 10 years, but instead of making it any old BS, I would say you have to have the BSN. To help pay for this stuff, I think alot of the moneys to help should come from the hospitals themselves, charging $10,000 a day for a bed, well I'm sure they have the money. They want us to get our BSN's well they need to step up to the plate and help out the universities so that they can expand their current offerings.

Specializes in NICU, High-Risk L&D, IBCLC.

I believe that the money to convert ADN programs to BSN programs would mostly come from the students themselves in the form of higher tuition. For my BSN program, I paid around $450 per credit hour for every nursing course I enrolled in. Would there be so much interest in a nursing career if tuition cost this much everywhere and nursing wages did not increase?

That leads right into what would happen to ratios. If nursing wages increased along with the rise in educational requirements for a bedside nurse (and I think they would have to), then we'd probably see a lot less nursing positions. Facilities would still need to control costs somewhere, and I'm thinking that raising ratios/cutting nursing positions would be a guarantee.

Speaking as a recent graduate from an entry BSN program and a brand new RN in orientation on a busy L&D floor, I don't feel like the extra BSN educational requirements prepared me any better than an ADN program would have to begin as a staff nurse. Did I receive a more rounded education in my BSN program? I probably did. But my BSN program, just like the ADN and diploma program, is for entry level nursing practice. Furthermore, it was my choice to go that route for my RN(and pay the hefty tuition rate) because I wanted to have the additional classes/clinical experiences, wanted the whole experience of going to the University, and wanted to earn a BSN. I never did it expecting that I would get paid a higher salary right off the bat or be better prepared than the ADN graduates. I would be really disappointed if that had been the case!

Just my :twocents: .

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Based on what you say, and the other facts before us, I am confident we won't see an all-BSN requirement to enter professional nursing come about any time soon, John.

I like what msadn said. A good point was made. By the time I finish my BSN, I will well surpass the amt of credits, classes and clinical hours that the typical BSN progam RN has. Therefore, should I get the better jobs and get paid more because I took a bunch more classes that made me "better educated "? Again, education doesn't equate to a nurse that can think on their feet, do critical thinking etc. I also agree with smiling blue eyes. Nurses need more experience with economics.

Why would BSN nurses be pressing this issue so hard when it would eliminate the edge they currently hold for certain positions? I don't really understand it, exactly. On the one hand, I understand the push for an all-BSN entry level, as it legitimizes the choices THEY have made for themselves. Human nature says that we like to have everyone else in agreement with us. What better validation of your own opinion of the superiority of BSN degrees over ADN degrees than a professional mandate? Beyond this natural desire to be "in the right all along", I can't quite explain it. Currently, there are positions to which only BSN nurses may apply. They seek to increase the competition for those positions by virtue of this desire.

If anything, having BSN as the minimum entry for practice absolutely ensures a new debate: whether BSN-prepared nurses are really qualified to hold positions that really should go to MSN nurses. BSN nurses become the "lesser" nurse; they become the "less educated", "non-professional" that they sought to erase. This thinking isn't new; it's been discussed on these boards forever. And yet, the expectation that having BSN as a minimum standard of entry somehow improves the outlook for all nurses erroneously continues. BSNs would suddenly find themselves no longer eligible for the very jobs they currently desire: they'd be outdone by MSNs, NPs. They would be sniffed at as "just" BSNs, who were too lazy to get an advanced practice degree. They would become the lowest common denominator on the food chain, where they currently place ADNs.

So all of this is just an absurd ego exercise where BSN's can think they're better than everybody else.

Because in reality ... this could easily worsen patient ratios at the bedside. Nobody would want to work at the bedside anymore and BSN's would have to fight with everybody else for non-bedside jobs because they don't have those special qualifications anymore.

Funny ... I thought BSN's were supposed to be smarter than us lazy ADN's but ... this doesn't sound very smart to me.

Personally ... I don't want the BSN for my ego, but I do want that investment to stand out and provide me with an advantage for better job opportunities.

:typing

Specializes in mostly in the basement.

a couple of thoughts on the endless debate---

the idea that BSN's are somehow the more vocal and seek to "put down" more than the oh so respectful ADN contingent is laughable. I can't count how many times my degree has been denigrated, called "just a couple of classes" , how ADN grads can run rings around me with their clinical skills, etc.

I advocate all BSN in order to elevate the profession. Not to put down anyone else's education. (I might have chosen ADN too if it would have got me my RN faster. In my particular case, it wouldn't have) I want an all "professional" workforce because I am tired of not being seen on par with many of our coworking disciplines. Is it ego? Sure, maybe. But our job IS so important and we are looked down upon and not taken seriously, like it or not, because most of us do have "just" a two year degree. (Yes, yes I know how long it really takes, and how hard it is, and .....I'm talking about perception). I'm only a year out of school and grossed more than 100k last year and yet I am still leaning to leave this job because nurses(we) just don't seem to like ourselves very much. Aren't you tired of being stepped on?

I know there are myriad road blocks to this becoming reality. I just don't get the fighting to keep us from being being viewed as a strong workforce who deserve to be compensated as professionals.

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.

Which would basically make BSNs like every other BS/BA degree. Out in the big wide world, all a BS/BA gets you is an entry level job. If you want more, you gotta get more. Not saying that's fair, but it's the way it is. A bachelor's degree is rapidly becoming meaningless.

* 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

To elevate the profession in the eyes of the rest of the medical world (are there really any other career fields with THREE SEPARATE MEANS TO THE SAME END?), and to stop all this *&%$ bickering that makes us look utterly ridiculous.

We are a profession. A professional degree is a baccalaureate. I'm not saying it's better or worse - I don't care about any of that crap. I'm not getting sucked into this is better and that is worse, and this is right and that is wrong. I don't have all the answers and I have great respect for anyone crazy enough to enter this profession, regardless of how you do it. The fact is this: your child's teacher has to have a BS or BA. Why don't we?

Specializes in MPCU.

Mandating BSN as the entry level to nursing simply will not work.

If we want more BSN's we should work on facilitating the transition to BSN. ADN to BSN requires three semesters of core nursing classes. One semester where the ADN proves that she is an RN-usually called a "bridge" semester. Also, isn't a little silly that a practicing nurse is required to have more clinical hours?

I believe the best approach is to help each other, rather than force each other.

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.
Mandating BSN as the entry level to nursing simply will not work.

If we want more BSN's we should work on facilitating the transition to BSN. ADN to BSN requires three semesters of core nursing classes. One semester where the ADN proves that she is an RN-usually called a "bridge" semester. Also, isn't a little silly that a practicing nurse is required to have more clinical hours?

I believe the best approach is to help each other, rather than force each other.

The clinical hours in an RN to BSN bridge are typically not the same clinical hours as ADN. They are hours in community health, managment, working with a nurse practioner doing assessments, a free clinic, a shelter for homeless teens, and teaching projects, shawdowing a director or VP of nursing, interviews, for examples. NLN approved RN to BSN programs have to have a clinical component. But it's definately not med-surg clinical type hours that you get in your ADN programs.

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