BSN and Associate Nurses Are Neck and Neck. Will This Change?

[allnurses]

AACN published The Impact of Education on Nursing Practice in 2015 which discussed multiple studies about ADN and BSN education. One of the more important statements is about Magnet status. Hospitals that have attained Magnet status, are recognized for nursing excellence and superior patient outcomes, have moved to require all nurse managers and nurse leaders to hold a baccalaureate or graduate degree. Hospitals in the process of applying for Magnet status must show plans to achieve the goal of having an 80% baccalaureate prepared RN workforce by 2020.

Then there are the studies that show that hospitals staffed with more BSN prepared nurses have better patient outcomes. This has been a hotly debated topic on AN. Here is one references:

In an article published in the March 2013 issue of Health Affairs, nurse researcher Ann Kutney-Lee and colleagues found that a 10-point increase in the percentage of nurses holding a BSN within a hospital was associated with an average reduction of 2.12 deaths for every 1,000 patients-and for a subset of patients with complications, an average reduction of 7.47 deaths per 1,000 patients. The study is titled "An Increase in the Number of Nurses with Baccalaureate Degrees is Linked to Lower Rates of Post-surgery Mortality."

One of the more prolific threads on AN was titled the difference between ADN and BSN nurses that was started in December 2014.

Many individual healthcare facilities have created policies that will affect the increasing number of nurses earning a BSN. Due to internal policies, the management at many hospitals across the US have been requiring currently employed LPNs and RNs with diplomas and ADNs to earn BSN degrees within a specified time frame. Many non-BSN nurses are being given an ultimatum. Is this right?

It is still being debated

So...what's your opinion? Is getting a BSN on your agenda?

How is the comparison between the number of ADN and BSN RNs at your place of work?

[old and tired nurse]

I am currently in a Rn to Bsn program. I have to say that for a nurse that has 33 years at the bedside, it is a slap in my face to be told that I am not good enough to be hired because I lack those initials behind my name. I have asked this question and no one seems to be able to answer it for me, how is art appreciation and American history going to make me a better nurse. I am a neonatal nurse and everyone of my nursing classes is geared towards adults, how does that help my practice at the bedside improve. Just a few thoughts for a very old and very tired nurse.

[Boomer MS, RN]

old and tired nurse said:

I am currently in a Rn to Bsn program. I have to say that for a nurse that has 33 years at the bedside, it is a slap in my face to be told that I am not good enough to be hired because I lack those initials behind my name. I have asked this question and no one seems to be able to answer it for me, how is art appreciation and American history going to make me a better nurse. I am a neonatal nurse and everyone of my nursing classes is geared towards adults, how does that help my practice at the bedside improve. Just a few thoughts for a very old and very tired nurse.

I am a huge proponent for every nurse having at least a BSN, but your point is well taken. If I ran the world as Queen or Emperor (don't I wish?), I would figure out some way to grandfather in nurses such as you to be exempt you from the new requirements. I don't know your age but am guessing you must be about 50 at least. This is how I see it: Nurses in that age group are facing college expenses for their children, perhaps caring for and helping aging parents with expenses and maybe considering retirement in the near future. I know these characteristics don't fit everyone later in life, but I feel strongly that we should not burden older nurses with the financial burden of getting a BSN toward the end of his/her career. I admit I do not know the age cut off to make that work. No one, however, asks my opinion about any of this. As I said, I think all nurses need a BSN, but what about commonsense in an older nurse's situation?

I'm sorry that you do not feel the courses are helpful or interesting, but a bachelor's degree curriculum is more than a ADN. Just the way it is. There are reasons for that. I can tell you are a very experienced practitioner who has cared for and helped many babies and families during your career. I applaud you for that. We used to call down the neonatal nurses often for help with the very little ones in our ED. Loved those neonatal nurses.

[BostonFNP, APRN]

old and tired nurse said:

I am currently in a Rn to Bsn program. I have to say that for a nurse that has 33 years at the bedside, it is a slap in my face to be told that I am not good enough to be hired because I lack those initials behind my name. I have asked this question and no one seems to be able to answer it for me, how is art appreciation and American history going to make me a better nurse. I am a neonatal nurse and everyone of my nursing classes is geared towards adults, how does that help my practice at the bedside improve. Just a few thoughts for a very old and very tired nurse.

What are the courses you are taking right now? Are you taking "Art Appreciation" and "American History"?

[kbrn2002, ADN, RN]

old and tired nurse said:

I am currently in a Rn to Bsn program. I have to say that for a nurse that has 33 years at the bedside, it is a slap in my face to be told that I am not good enough to be hired because I lack those initials behind my name. I have asked this question and no one seems to be able to answer it for me, how is art appreciation and American history going to make me a better nurse. I am a neonatal nurse and everyone of my nursing classes is geared towards adults, how does that help my practice at the bedside improve. Just a few thoughts for a very old and very tired nurse.

I am with you on this. I entered nursing as a second [maybe third] career and am already slightly north of 50. Fortunately I live in a region where the lack of a BSN is not a problem as I would feel much the same as you were my employer to force me back into school to do a job I've already been doing for so long. There is zero financial incentive for me to get a BSN at this point and a lot of financial loss in paying for a degree that will not net me one red cent more in my current job.

[Horseshoe, BSN, RN]

It seems a lot of hospitals want to have their cake and eat it, too. They "prefer" a BSN, because it's obviously superior to the education of an ADN and it provides them with some kind of benefit to hire a BSN prepared nurse over the ADN prepared nurse. BUT, they won't pay the BSN prepared nurse significantly more, because obviously, it's not superior to the education of an ADN.

They are talking out of both sides of their mouths, and it's complete and utter BS.

[BostonFNP, APRN]

Horseshoe said:

It seems a lot of hospitals want to have their cake and eat it, too. They "prefer" a BSN, because it's obviously superior to the education of an ADN and it provides them with some kind of benefit to hire a BSN prepared nurse over the ADN prepared nurse. BUT, they won't pay the BSN prepared nurse significantly more, because obviously, it's not superior to the education of an ADN.

They are talking out of both sides of their mouths, and it's complete and utter BS.

This is simple supply and demand, can you really blame hospitals? They have a chance to get more at the same cost so that choose to do that. It's flawed logic to think that just because education and benefit to them is better that they would simply offer to pay more money for it, unless they are made to by reducing supply.

[OHNBJL]

I agree totally. Give me an experienced nurse any day. However, it is now all about the degrees. I'm pushing 60 and do have a bachelors but I got it when I was 40 because in order to have my Occ Health Cert it was going to be mandatory.

Also, there were 4 of us who took the Occ Health Boards. The 2 of us that passed had bachelors. Lots of question on the boards were administrative not nursing care. Sad but true. Nurses in their 40's and 50's are stuck. Comply or get left behind. Not a good feeling

[Susie2310]

What would be the effect on a facility if it required older, experienced nurses, to obtain a BSN? Some of those nurses, who would be more highly paid than newer nurses, would leave their employer.

[Horseshoe, BSN, RN]

I have a BSN already. I would be peeved if I had to pay for one out of my own pocket now because it is deemed to be superior, only to be told afterwards that my advanced education didn't pay more. I don't blame the ADNs who feel ill used by this.

[Buyer beware, BSN]

@CKPM2RN

You got that right! You nailed it. For the last 30 years at least there has always been a nursing shortage. I know. I was there. By the way do you ever hear the MD's say "there's a doctor shortage, we've got to open more schools and crank out more doctors." No you don't! No Florence Nightingales there. They keep their numbers low so as to not diminish their overall economic base.

For this you can thank the so-called nursing leadership for bending over backward to do the bidding of the hospital lobby. So as the expression goes: "spew them out to sell them out to the lowest bidder." Hey people as much as most of us are very empathetic folks, they take advantage of that ethic. Remember, healthcare is a business. The days of the not-for-profit, this is a religious calling are long gone my friends

[gizmopacurn]

You make an excellent point! I would love to see the numbers of this study isolated to show years of service while being ADN to the results of mortality. Another bit of info I would like to see in this study of showing decreased mortality with increased RN's holding BSN is the patient ratio. Are they accounting for the patient to nurse ratios AND ADN to BSN? Maybe the nurses holding ADN degrees have a higher patient/RN ratio and the BSN nurses lower.

I am currently working on my BSN right now for job security and I feel that it is not a waste of time, I have learned a lot. I went into it thinking I wouldn't get much out of it but I was wrong.

[Buyer beware, BSN]

rzyzzy said:

I don't doubt they were happy to do it, but it's a tremendous waste of a resource to have them at the bedside instead of teaching/precepting or managing the department.

You don't use a CPA to do 1040 EZ's, you don't ask a master chef to prepare rice-a-roni - or if you do, they use their knowledge, experience & training to delegate those tasks appropriately.

By allowing a very few educational elitists to control the narrative, they've been allowed to do some very bad things to the profession of nursing. Like running all the LPN's out of hospitals & attempting to do the same thing to ADN's. You don't need a bachelor's degree to hand out pepcid. In my state, an "elite" CNA (or "med tech") can do it.

With all due respect, the sooner you can disabuse yourself of the notion that degrees other than warm bodies have always been the apple of the employer's eye (mainly hospitals), the quicker you will realize that degrees, depending on what you, do are merely window dressing. I would bring your attention to the oxymoron Dr/Nurse as an example. Even this vaunted designation when doing bedside nursing is "just one of the girls/boys."