ADN vs BSN nurses

roser13, ASN, RN · Feb 3, 2010

Oh no.....here we go again. All RN's take the same state boards and carry the same license. Scope of practice is the same. Salary is often the same; sometimes there is a small (.25 to 1.00) hourly difference. "Does BSN nurses have better patient outcome? Are they more effective?"That is very much personal opinion/experience. It's also a very hotly debated topic both here and in the nursing community. You will likely receive either tons of replies/comments or next to none, because this topic has lots of threads here, most all of them very hotly debated.In other words, you will find some whose experience with BSN/ASN RN's is that the BSN nurses are better prepared. You will also be just as likely to find those whose experience has been that ASN RN's are better prepared in actual patient experience.

ChristineN, BSN, RN · Feb 3, 2010

What are the differences between ADN and BSN nurses in terms of their nursing practice?
Does BSN nurses have better patient outcome? Are they more effective?

In terms of staff nursing practice, there should be absolutely no difference in their models of care. In terms of research, management, etc a BSN nurse may be more prepared, but in terms of patient care, both are equal.

PMFB-RN, RN · Feb 3, 2010

What are the differences between ADN and BSN nurses in terms of their nursing practice?
Does BSN nurses have better patient outcome? Are they more effective?

*** No difference in practice. One thing to remember is that a large percentage of BSN prepared nurses started as ADNs or diploma prepared nurses. Every ADN nurse is just two years of part time, online work away from being a BSN nurse.

In those areas where the ADN is actually a two year degree (a minority as far as I can tell) the ADN who goes the RN to BSN rout is at a large advantage over the direct BSN nurse. I will use where I live (Wisconsin) as an example. Our ADN programs are designed to be done in two years and have no college class prereqs, just CNA, HS graduation and CPR. Many, many people graduate in two years from start to finish. Two years of community college for around $5,500 total cost. Then two years of full time work while also doing an online RN to BSN. Many hospitals, like the one where I work will pay for a BSN. The ADN nurse can get their BSN at hospital expense in two years while making (over two years) around $100K, have had health insurance for two of those years and have two solid years of RN experience. Cost of a traditional BSN at a UW school is around $45K. Lets compair where they are at the end of 4 years.

ADN to BSN nurse:

Licensed RN

BSN

2 years RN experience

Health insurance for two years

Made around $100K

Cost around $5,500

Traditional BSN:

Licensed RN

BSN

No experience

Made no money

Cost around $45K

Currently most of Wisconsin's 16 public technical colleges have waiting lists from one semester to several years long. I think a waiting list longer than a year will negate many of the advantages of the RN to BSN rout.

313RN, BSN, RN · Feb 20, 2010

i have a bsn and i doubt there's much difference in outcomes between adn and bsn nurses if all the other variables (pt, facility, md's etc) are basically equal. i have no evidence to base this on, just a gut feeling.

when i've talked to adn nurses and we discuss school they're often a little self-deprecating, saying something like "i only have an adn". i always ask "does your license say rn?" when they say it does i reply "so does mine".

whichever of us is the better nurse depends on a lot of things, not just the degrees i have. i suspect who had the most sleep the night before will have a larger impact on the quality of care than a degree does, everything else being equal.

RNmilwife · May 28, 2011

I know this is a fairly old thread but I'm curious as to why hospitals are encouraging ADNs to go back for their BSN but offer no more pay for it? Where I work now, The BSN makes no more money than a ADN. If we're going to be paid the same and do the same work, what's the point. (Not that I'm not furthering my education, just saying)

citylights89, BSN, RN · Jun 2, 2011

^ I think it's because a lot of them may be shooting for Magnet status, or so I heard.

Moogie · Jun 3, 2011

I know this is a fairly old thread but I'm curious as to why hospitals are encouraging ADNs to go back for their BSN but offer no more pay for it? Where I work now, The BSN makes no more money than a ADN. If we're going to be paid the same and do the same work, what's the point. (Not that I'm not furthering my education, just saying)

That's a really good question! The lack of a BSN differential is a significant barrier to furthering a diploma or AD nurses' education.

Does your hospital at least offer tuition reimbursement to decrease the costs of going back to school? If it doesn't offer a differential, at least it should help nurses with the cost of higher education, especially if it's encouraging nurses to go back for the BSN.

RNmilwife · Jun 3, 2011

They do offer some tuition reimbursement to a certain amt each year. Problem is ( for me anyway) is they want a 2 year commitment, and I'm a military wife. Can't guarentee that kind of time.

Moogie · Jun 4, 2011

Since your husband is in the military, you might be eligible for some help with your education. My husband is a veteran and was deployed three times. Because of changes in the GI Bill, he was able to transfer his educational benefits to me and that enabled me to finish my master's.

The most recent changes in the GI Bill allow one half of the monthly living stipend for distance education. You might want to look into an online program if you want to go for your BSN or a master's.

Thank your husband for his service. :redbeathe

goingCOASTAL · Jun 17, 2011

I've been a nurse for 16 years, and this debate has gone on longer than that. I've been an ADN nurse for most of that time, and have recently completed my BSN. While my experience as a nurse helped making going back to school much easier than it was the first time around, I actually learned a lot. I know I'm a better nurse now because of the BSN ... despite the hype, it was a lot more than just "management" - in fact, of the eight or so nursing courses I had to take, only one of them dealt with leadership.

But, that's just anecdotal. The facts are in the research. If you're not aware of this article, please read "Educational Levels of Hospital Nurses and Surgical Patient Mortality" published way back in 2003. When removing all other factors, the study showed that a "10% increase in the proportion of nurses holding a bachelor's degree was associated with a 5% decrease in both the likelihood of patients dying within 30 days of admission and the odds of failure to rescue" (Aiken, 2003).

And then ... consider the facts from real life. Even down here in the South, hospitals faced with a glut of applicants are choosing BSNs over ADN students more than they ever have before. From what I've heard, it's difficult for an ADN nurse in Houston to find a job in the Medical Center. My hospital prefers them as well - and they are fully aware of the science on this matter.

My advice to everyone - if you have an ADN, find a low-cost way to degree-up (I completed mine at UT-Arlington online). If you're taking pre-reqs to get into nursing school - take the extra time and get your BSN. Hospital doors are literally locking on ADN applicants.

Aiken, L., Clarke, S., Cheung, R., Sloane, D., & Silber., J. Educational levels of hospital nurses and surgical patient mortality. Journal of the American Medical Association, 290 (12), 1617-1623.

almostnurse2 · Sep 14, 2016

I know this is an incredibly old post, but my best friend and I have debated this issue for the past few years. We have come to a reasonable conclusion to the question of ADN vs. BSN...which is better? The answer really depends on your personal situation. Location, program types vary from state-to-state, time, travel, child care arrangements, personal economics, etc. The right answer is to go with whatever route is best for you. Look at all your options. Ignore what everyone else says and do what is best for you.

Both of us are non-traditional students, meaning we are becoming second-career nurses. We are both single parents. My son was grown, but she still had a little one at home to support. We began school right around the same time. She went the ADN route at the local community college near her home. I looked into the ADN route at the local community college near my home and was told that there was a 6 year waiting list unless you scored a 100% on your TEAS. Of course, I only scored a 98%. Well, if I had to wait 6 years, I probably would never go back to school. In Illinois you have to complete approximately one year of prerequisites before entering the two-year ADN nursing program, meaning it takes a minimum of 3 years to get a 2 year degree. At this point, I began looking into the 4-year BSN programs at local private universities. At first, I was deterred by cost, which is significantly higher than going the ADN route. But after meeting with financial aid department at the school, I learned that I qualified for several scholarships and grants, which made the cost much more reasonable. I looked into attending nursing school at the community college my friend was attending, but the out-of-district tuition and travel expenses would have been more than what the school with the BSN program offered me. So I applied and was accepted. I am now in my very last semester and am set to graduate in Dec. 2016.

My friend started her nursing program, became a CNA and later became an LPN. Due to unexpected life events, she had to leave school. She obtained a job she absolutely loves working as a LPN at a really great private nursing home. She received certifications for wound care and Alzheimer's care and a raise with each certification. Between her salary and overtime, she makes more money as an LPN than what the local hospitals near my home pay new grad BSN nurses. This may not be the case everywhere, but that is the situation here.

My situation is a little different. My son graduated high school in 2013 and joined the Navy. I moved in with my boyfriend who was really supportive of me going to nursing school. I was able to quit my full time job as a Certified Medical Assistant and take a part time position. Without his support and help, there would be no way I could possibly work full time to support myself and attend nursing school full time. If you go the BSN route, make sure you live with your parents, spouse or someone willing and able to provide a roof over your head. It is really difficult trying to be successful in nursing school when you are working too much! I know lots of people do it, but I couldn't. Another word of advice: Know and accept your limitations!

Another example of how location affects your decision: My cousin's husband just graduated with his ADN and was immediately hired as an ICU nurse at a large hospital in Indianapolis, IN. The hospitals here in northern IL for the most part only hire BSN's. Ask around where you live. If you can get hired as an ADN at a hospital in your area, let them pay for your BSN.

So, the answer to the question - Which is better ADN or BSN? Depends on your personal situation, location, finances. Do your research, look into all pathways, then just do what is best for you. Every nurse has a different path in their career. No two nursing students' experiences are ever the same. I noticed this even with the girls I attend school with. We are working towards the same goal, but each of us has our own path.