ADN or BSN: What's the Big Deal?

[allnurses]

I was talking about this topic with one of my younger nurse friends. She shared the following comments with me.

Quote

Funny to me that 20 years ago when I graduated with my BSN, I was told that ADN/ LPN programs were being phased out and that minimum entry level nursing positions would soon be BSN. Fast forward 20 years and it appears ADN and LPN programs are going strong.

I want to start by saying that quality bedside nursing care can be provided no matter the advanced degree or not. As a new graduate, I survived and so did my patients thanks to the care and support and knowledge of many many LPN's and ADN's. There are also plenty of not so great nurses out there with various degrees. That being said, there has been much discussion, surveys and studies done regarding the differences in the career of a BSN prepared nurse, LPN, and an ADN prepared nurse. The results of the 2015 allnurses salary survey presented that 39% of respondents held an ADN and 39% held a BSN. As we are about to release the comprehensive 2017 allnurses nursing salary results, we will see where the trends have gone.

So what's the big deal...as long as you are an RN? The title of RN whether earned through a Degree or Diploma program will allow you to provide the same level of basic nursing care as we see in hospitals, clinics and doctors offices. The BSN prepared nurse, however, has many more options that require higher responsibilities, therefore higher pay. This is due to the more in-depth coursework in physical and social sciences including public health, nursing research and nursing management. An RN with a BSN can choose a career in nursing education, public health, or clinically focus in specific diseases or adult, pediatric, geriatric care. A BSN is required to be considered for many positions or to further one's education to focus on speciality care.

In 2010, the Institute of Medicine introduced new demands on the nursing field when it set a target goal for 80% of all nurses to hold bachelor's degrees by 2020. This goal was derived from academic research indicating that patients receive better care in hospitals when the majority of nurses hold a BSN or higher. The American Nurses Credentialing Center (ANCC) devised the Magnet Recognition Program to draw attention to top healthcare facilities. This recognition means that 100% of the organization's nurse managers have a BSN or graduate degree. "Achieving Magnet status also means that there are generally a higher number of nurses holding a BSN degree for jobs in direct patient care. Approximately 50% of all nurses associated with direct patient care in a Magnet-recognized hospital currently have a BSN."

The 2017 allnurses survey results have shown some slight shifts. In 2017 the percentage of BSN prepared nurses has remained steady at 39% while ADN's have dropped by 2 percentage points. The number of MSN's have increased by 1%. Why might this be? Is there a greater demand for advanced practice nurses? Are employers encouraging and/ or supporting advancing degrees? Is retirement a factor in the decrease in ADN's? As our final results are revealed, new light might be shed on factors influencing the slight shift from last year to this year. Will the trend continue? Are you thinking of furthering your education? We want to hear from you!

We as nurses should support each other in furthering education, as well as respecting those who have years of bedside experience but might not have higher education degrees. As the field of nursing continues to grow our knowledge base will be required to change to keep up with the technology and level of care.

The 2017 allnurses salary survey results will be released soon. It will be interesting to see if the interactive survey results show pay differences based on degree as well as location, speciality and gender.

2015 allnurses Salary Survey Results

[michaelg510]

Has anyone had issues getting a job as a result of not having a bsn?

[JillRN]

I'm a 50 year old diploma RN. I received an excellent hands on education at the school of nursing ran by the hospital. We all secured jobs at the hospital in the specialty we desired. I've worked with LPNs that have functioned as a masters degreed nurse would. I've worked with MSNs whom we've scratched our heads at as even the simplest of nursing knowledge seemed to evade them. Will we ever find a happy medium?

[BlackbirdRN]

I graduated with my BSN in 1981 and was also told that ADN programs would be phased out.

The bottom line is there is a difference between ADN nurse and BSN ones and it is not about research and it is not about management. It is about thinking bigger & broader with theory based decision making. The ADN new nurse will always out perform in clinical skills the BSN nurse in the first 6-9 months but after that, EVERYONE has figured out how to start IVs, put in foleys and NGs, do dressing changes, change beds with patients still in them.

It is after that when your patient is febrile but their white count is stable, they are SOB but their lungs are clear and their urine specific gravity is unchanging though they are putting out tons of urine. That is where theory based learning of pathophysiology comes in to help you decide not only to call the doctor but what to tell him. What else did you think to check on the patient before calling?

BSN nurses may or may not make better managers because they don't really teach that in a BSN program but what they do teach is communication analysis, psychology and sociology prerequisites help you figure out why people verbally respond differently. What motivates people.

So stop with the comparisons. They are different. ADN nurses make excellent direct care providers while BSN nurses have a year of extra theory and many prerequisite classes to further their ability to problem solve and analyze situations to develop a path to solve problems.

[MunoRN, RN]

BlackbirdRN said:

I graduated with my BSN in 1981 and was also told that ADN programs would be phased out.

The bottom line is there is a difference between ADN nurse and BSN ones and it is not about research and it is not about management. It is about thinking bigger & broader with theory based decision making. The ADN new nurse will always out perform in clinical skills the BSN nurse in the first 6-9 months but after that, EVERYONE has figured out how to start IVs, put in foleys and NGs, do dressing changes, change beds with patients still in them.

It is after that when your patient is febrile but their white count is stable, they are SOB but their lungs are clear and their urine specific gravity is unchanging though they are putting out tons of urine. That is where theory based learning of pathophysiology comes in to help you decide not only to call the doctor but what to tell him. What else did you think to check on the patient before calling?

BSN nurses may or may not make better managers because they don't really teach that in a BSN program but what they do teach is communication analysis, psychology and sociology prerequisites help you figure out why people verbally respond differently. What motivates people.

So stop with the comparisons. They are different. ADN nurses make excellent direct care providers while BSN nurses have a year of extra theory and many prerequisite classes to further their ability to problem solve and analyze situations to develop a path to solve problems.

While it's true this hasn't always been the case, there is nothing currently fundamentally different about ADN and BSN curriculum that would create a different way of thinking. In the states where curriculum is not already standardized by law, ADN programs have widely adopted BSN curriculum due to their articulation agreements with BSN programs. As for prerequisites, these articulation agreements also usually standardize the pre-reqs, the only excpetions being a nutrition and sometimes statistics class.

[Wuzzie]

BlackbirdRN said:

I graduated with my BSN in 1981 and was also told that ADN programs would be phased out.

The bottom line is there is a difference between ADN nurse and BSN ones and it is not about research and it is not about management. It is about thinking bigger & broader with theory based decision making. The ADN new nurse will always out perform in clinical skills the BSN nurse in the first 6-9 months but after that, EVERYONE has figured out how to start IVs, put in foleys and NGs, do dressing changes, change beds with patients still in them.

It is after that when your patient is febrile but their white count is stable, they are SOB but their lungs are clear and their urine specific gravity is unchanging though they are putting out tons of urine. That is where theory based learning of pathophysiology comes in to help you decide not only to call the doctor but what to tell him. What else did you think to check on the patient before calling?

BSN nurses may or may not make better managers because they don't really teach that in a BSN program but what they do teach is communication analysis, psychology and sociology prerequisites help you figure out why people verbally respond differently. What motivates people.

So stop with the comparisons. They are different. ADN nurses make excellent direct care providers while BSN nurses have a year of extra theory and many prerequisite classes to further their ability to problem solve and analyze situations to develop a path to solve problems.

Complete and utter BS. There is NOTHING in a BSN program that teaches problem solving, critical thinking or big-picture concepts differently than that of an ADN program! Where did you come up with such a ridiculous idea? And FTR, that wasn't the case when you were in school either. Diploma/ADN programs taught theory and management and required the same nursing prerequisites as BSN programs with the exception of statistics. You make it sound like ADN's are order-following robots incapable of putting together a coherent thought but dayum they can sure make tight hospital corners. Too bad their patient died because they were too stupid to understand the significance of a left-shift and the BSN was on break. Get over yourself.

[Lins25]

I have my ADN and was ADON for 5 years and currently teach CNA students. So, management and teaching are DEFINITELY options for ADN nurses!

[Lins25]

Of COURSE you were told it was being phased out! LOL! I'm sorry, but nursing school was 2 years for me and 2 years for you. Those extra Freshman and Sophomore level course prerequisites do NOT teach critical thinking and problem solving in nursing.

[BostonFNP, APRN]

It's much more helpful to consider this trend on a national level rather than an individual level which seems to get very personal for posters. What's behind the national trend what the AN survey showed?

[Wuzzie]

BostonFNP said:

It's much more helpful to consider this trend on a national level rather than an individual level which seems to get very personal for posters. What's behind the national trend what the AN survey showed?

I agree it's the trend that is interesting but when somebody starts saying only BSN's are able to actually use their brains and any nurse with less than a BSN is only competent to make beds (because vitals and medication require actual thinking) it does get personal.

Frankly I think what's behind the trend is more and more people going into nursing with no intention of staying at the bedside for longer than the bare minimal time and older nurses trying to protect their jobs. We had an amazing nursing administrator who after 25 years in her position was ousted because she didn't have her Masters. Combine that with the very real probability of states going to BSN only as entry into the profession the handwriting is on the wall.

[Here.I.Stand, BSN, RN]

BlackbirdRN said:

I graduated with my BSN in 1981 and was also told that ADN programs would be phased out.

The bottom line is there is a difference between ADN nurse and BSN ones and it is not about research and it is not about management. It is about thinking bigger & broader with theory based decision making. The ADN new nurse will always out perform in clinical skills the BSN nurse in the first 6-9 months but after that, EVERYONE has figured out how to start IVs, put in foleys and NGs, do dressing changes, change beds with patients still in them.

It is after that when your patient is febrile but their white count is stable, they are SOB but their lungs are clear and their urine specific gravity is unchanging though they are putting out tons of urine. That is where theory based learning of pathophysiology comes in to help you decide not only to call the doctor but what to tell him. What else did you think to check on the patient before calling?

BSN nurses may or may not make better managers because they don't really teach that in a BSN program but what they do teach is communication analysis, psychology and sociology prerequisites help you figure out why people verbally respond differently. What motivates people.

So stop with the comparisons. They are different. ADN nurses make excellent direct care providers while BSN nurses have a year of extra theory and many prerequisite classes to further their ability to problem solve and analyze situations to develop a path to solve problems.

Do you honestly think that my fellow ICU nurses and I really don't know how to look at the big picture, critically think, and know what info is pertinent? Honestly? Yes, my screen name says "BSN" -- I have had that

What of this extra year of theory? I learned about qi, auras, chakras, and self-care in nursing theory. My prof even brought her divining rods to class, and showed us how she used them to find out where in her yard the qi was most favorable to make her labyrinth. We also learned how to make the hospital room more feng shui.

I learned literally ZERO critical care content; 100% of CC nursing (aside from on-the-job) I learned in my ADN program.

To be fair I learned some useful nuggets. One of my favorite classes ever was.... Geriatric Nursing. It was quite LTC focused. That was the only non-community based nursing class in the entire bridge program.

I'm not sure where you are getting your info from, but it's apparently not a very reliable source.

[AJJKRN]

BlackbirdRN said:

I graduated with my BSN in 1981 and was also told that ADN programs would be phased out.

The bottom line is there is a difference between ADN nurse and BSN ones and it is not about research and it is not about management. It is about thinking bigger & broader with theory based decision making. The ADN new nurse will always out perform in clinical skills the BSN nurse in the first 6-9 months but after that, EVERYONE has figured out how to start IVs, put in foleys and NGs, do dressing changes, change beds with patients still in them.

It is after that when your patient is febrile but their white count is stable, they are SOB but their lungs are clear and their urine specific gravity is unchanging though they are putting out tons of urine. That is where theory based learning of pathophysiology comes in to help you decide not only to call the doctor but what to tell him. What else did you think to check on the patient before calling?

BSN nurses may or may not make better managers because they don't really teach that in a BSN program but what they do teach is communication analysis, psychology and sociology prerequisites help you figure out why people verbally respond differently. What motivates people.

So stop with the comparisons. They are different. ADN nurses make excellent direct care providers while BSN nurses have a year of extra theory and many prerequisite classes to further their ability to problem solve and analyze situations to develop a path to solve problems.

Drank the indoctrinated koolaid did ya? Too bad all that critical thinking you posses didn't help with figuring out this fairly obvious topic (in all of your 20+ years of nursing...).

I know the above comment is childish. It just floors me to no end that supposed to be educated professionals still need to fluff their egos.

[mmc51264, BSN, MSN, RN]

One thing that I am noticing is that where I work, many of the nursing schools are requiring preceptors to have a BSN. This is sad because we have many veteran nurses that are being grandfathered in and are not going to be required to get their BSN and are the best nurses I have seen, yet now all of a sudden, they cannot precept students (they can new hires, ironically). I did the ADN, work the went back for my BSN. I think that is a great way to do it. The BSN was more meaningful learning after working a year.