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?

[2mint]

macawake said:

the BSN nurse takes on a 25% reduced patient load compared to the ADN nurse...

Love your laser focus...

[OHNBJL]

I totally agree. It's all about the bucks. If insurance companies can use the data to prove that BSNs make less errors than ADNs that's what is going to be required.

[renaia]

Reading things like this cause me dissonance. I'm entering nursing school for my ADN as a 2nd career now that my daughter is almost old enough to attend school. I have a BS in an unrelated field (psych) and am still paying the loans off from my Undergrad.

I COULD do a 1 year accelerated BSN for 26k OR I could get my ADN for less than 1/4 of that.

I made a post and was basically told that unless I get a BSN I won't be able to get work. I am unsure if this is realistically the case or if there is just a kind-of looking-down-your-nose on ADNs.

At the end of the day I HOPE I can get work with an ADN and can do a rn to BSN after I am more established and if I had 26k to throw around I would most definitely go the BSN route, but as it stands, I have a family and we just can't afford that right now.

Is it truly the case that ADNs are not employable???

[rzyzzy]

The adn job-crunch may be overstated - you might have a bit of a fist-fight to get into a hospital position (you might not, too), but ltc, home care, dialysis, & probably a hundred other sub-areas still want & need adn's. If you're in a town with one hospital, and they require a BSN, well, that's it. My city has 4 major hospital chains & they all "prefer" bsn's, but if you take a job there as a pct or a tech while you're in adn school, you nearly always get hired upon graduation. A few other adn's sneak in around the edges if there's a staffing shortage, they know someone, or if they interview well. A few miles outside the major cities & you might be hired the day after you pass the nclex.

[PatMac10,RN, RN]

I am in a be in their's who got their BSN not too long after completing my initial licensure. I can honestly say that my RN to BSN program did not dramatically increase my clinical knowledge and competency.

Do I feel the program was a waste? Not really. The program in the degree our requirement for further opportunities in nursing in the future. So in that aspect the degree has served its purpose.

However, my BSN program did not teach me how to write a research paper or the basic principles and applications of clinical research. Only graduating 3 years ago from my associate degree program, The program I attended was what was considered a "new Age" ADN program.

When I say "new age" I mean that our program director prepared us to be able to transition into higher levels of learning from the start. We wrote numerous APA formatted research papers throughout every semester. We completed 2 major Clinical capstone projects, the latter of which each group was required to all participate in presenting at a critical care Symposium at a local hospital.

We completed community health rotations at the health department, a child care center, and with home health. Although we didn't have a separate class entitled community health.

I realize that many ADN programs are not formulated like this. Many students from other local ADN programs were always baffled at the requirement of our program.

My point is, I don't feel the BSN is a waste as long as it serves a purpose to the individual Attaining it. If I, knew, without a shadow of a doubt that I could work bedside until my late 60's (and I still may end up doing that) I would likely never have gotten a BSN, if I wasn't obligatory for my job.

I knew from the get go, However, that I may want to pursue other things later in my life, this I went to an ADN program to save time and a lot of money.

Both ADN and BSN programs have their place.

I will not start on all of these studies about the increase outcomes of BSN nurses. I am a believer that education and knowledge is precious and valuable, despite what letters it gives one after their name in the end.

[PatMac10,RN, RN]

renaia said:

Reading things like this cause me dissonance. I'm entering nursing school for my ADN as a 2nd career now that my daughter is almost old enough to attend school. I have a BS in an unrelated field (psych) and am still paying the loans off from my Undergrad.

I COULD do a 1 year accelerated BSN for 26k OR I could get my ADN for less than 1/4 of that.

I made a post and was basically told that unless I get a BSN I won't be able to get work. I am unsure if this is realistically the case or if there is just a kind-of looking-down-your-nose on ADNs.

At the end of the day I HOPE I can get work with an ADN and can do a rn to BSN after I am more established and if I had 26k to throw around I would most definitely go the BSN route, but as it stands, I have a family and we just can't afford that right now.

Is it truly the case that ADNs are not employable???

I am from a rural area and had 4 job offers 3 months before graduation. That's with a local BSN program cranking out 60-80 grads a year. Of course this may not be Ye case everywhere. Do research. It may be more difficult for you, but it may not be impossible. Your first job may not be in an area you want, but enroll in a RN to BSN quickly and get some work experience.

Getting some work experience as a CNA in hospital may help in acquiring a job too.

[Palliative Care, DNP]

I started an RN to BSN program the same month I graduated from my ADN program. Not because I felt it was better but because I realized it was the only way to move up or get into graduate school. I honestly feel like the courses to complete the BSN were crap. Nursing theory being the worst and most useless. However, without those courses and that degree, I would not have my DNP now. The one thing that's consistent with nursing education is that the higher the degree the more useless courses.

[Horseshoe, BSN, RN]

renaia said:

I made a post and was basically told that unless I get a BSN I won't be able to get work. I am unsure if this is realistically the case or if there is just a kind-of looking-down-your-nose on ADNs.

Is it truly the case that ADNs are not employable???

Good grief, it has nothing to do with "looking down your nose." It is VERY regionally specific. In SOME areas, new grad ADNs are having trouble getting jobs in hospitals that voice a "BSN preferred" or even "BSN required" perspective. In other areas, new grad ADNs have no trouble being hired into their preferred units in great hospitals.

What you need to do is research the job postings in your geographical area to see if there is a BSN required or BSN preferred mentality among the employers. That will give you your answer.

I work with a nurse who told me just yesterday that she cannot find a job at any hospital in my city with her ADN. She is a new grad and said she must get experience elsewhere in order to be hired at a hospital because they are all saying that they are not hiring new grads unless they have the BSN. They DO hire experienced nurses without the BSN. Whether or not this is "fair" is pretty much irrelevant. It's simply her reality.

Your area may be entirely different, particularly if it is experiencing a nursing shortage.

[Daddie O, BSN, RN]

I am about to start in an accelerated BSN program. I have no experience working as a nurse, but it seems obvious that experience would be the greatest asset when it comes to patient outcomes. That being said, the requirements to get into a BSN program vs an ADN program locally are significant.

To get into an ADN at a local community college you need to take 4 prerequisite courses (chem, micro, a&p 1&2), have a minimum GPA of 3.0, and score a 70 on the TEAS in order to get into the lottery system which picks 60 students. To get into a BSN program at the state university you need an Associate's Degree that includes 12 prerequisite courses (the four science I previously mentioned, along with psyc, human development, nutrition, critical thinking, statistics, sociology or cultural anthro, and writing), and because of the competitiveness you pretty much need a 4.0 GPA and a score of 90 or above on the TEAS to get into the merit based system which picks 80 students. Both programs are 2 year programs, the ADN costs about $6K and the BSN costs about $15K. Both programs are highly competitive, with the BSN program being much more so. Every BSN student is essentially an honors student at the top of their classes. Does being an honors student automatically make it they will be great nurses? No, of course not.

CSUS has 2,000 pre-nursing students alone, not to mention all the other community colleges, yet there are only 80 spots per semester, hence the competitiveness. Why only 80 spots? I am told it is because there are a lack of nurse educators due to the disparity between what a BSN makes in the field and what an educator makes.

Do I think obtaining a BSN is automatically going to make me a better nurse than an ADN? Of course not. I do know that in the current job market, having a BSN will give me an advantage when it comes to being hired. I know having a BSN will open pathways to more advanced nursing education. For me, spending the extra $9k and doing the extra work required to get a BSN is worth it.

[AutumnApple]

renaia said:

Reading things like this cause me dissonance. I'm entering nursing school for my ADN as a 2nd career now that my daughter is almost old enough to attend school. I have a BS in an unrelated field (psych) and am still paying the loans off from my Undergrad.

I COULD do a 1 year accelerated BSN for 26k OR I could get my ADN for less than 1/4 of that.

I made a post and was basically told that unless I get a BSN I won't be able to get work. I am unsure if this is realistically the case or if there is just a kind-of looking-down-your-nose on ADNs.

At the end of the day I HOPE I can get work with an ADN and can do a rn to BSN after I am more established and if I had 26k to throw around I would most definitely go the BSN route, but as it stands, I have a family and we just can't afford that right now.

Is it truly the case that ADNs are not employable???

People have already pointed out that the answer to your question changes drastically from area to area.

I will go a step further and say it's also personal, not just geographical. In other words, two people. ........graduates of the same school, live in the same area and likewise similar in every other way that matters...............will have completely different experiences. That's what I've observed anyway.

The variables that make their experiences so different often are personal and private. Hence, when faced with a question such as yours, that information remains undisclosed. So it is folly for us to take anyone's opinion of the job market too seriously. Its a personal experience.

A good example: Knew an ADN nurse who constantly insisted you needed a BSN for hospitals to even bother to interview you. I knew this not to be the case and in fact tried to inform her this assumption was incorrect. My assertions that you could be hired with an ADN were met with bitterness though so I gave up. The truth was (I found out later from her) that she had filed multiple times for workmans comp. She never received benefits though which made me wonder if she hadn't earned a reputation for being and injury faker. Add to the mix the fact that her license had in the past been put on hold (something to do with her mother turning her in for child abuse) and..........you can see why she had problems getting interviews.

Imagine this girl as a AN member now, posting an answer to your question. She isn't going to tell you all that. She'll just give you her standard answer that she told me: "Oh boo hoo, no interviews for me and its all because I only have an ADN."

Another example: A guy I knew from school contacted me and said he was out of nursing. This was only three years after graduation. He too believed he was not being hired for jobs because he had an ADN, not a BSN. Truth was: He was telling his interviewers he could not work any shift other than daylight, and he could not work holidays. He figured they should be Ok with that since he had his kids on most holidays.

Can you imagine having used his opinion (that he was not being hired only because he lacked a BSN) as a key to deciding what was best for you?

Our encounters with the job market are personal experiences. My advice would be to determine what is best for you from what YOU see for yourself, do the best you can with what you have and move forward. If you are truly applying yourself to what you do, you have a better chance of having a positive experience yourself.

Its good to take advice from others and to hear other opinions but...........different people with different agendas have different experiences. Not to mention not everyone is honest too.

[siegolindoRN]

that sad part in the battle between ADN and BSN is that someone entering nursing as a second career with a previous bachelors education will be forced to spend more money in getting another bachelors degree (depending on year graduated may/may not have credits transferred) in order to have a better chance in this competitive market. The scholars in our professions can sometimes lose sight of reality when creating policy.

[JVerne07]

I'm a student set to complete my ADN in less than six months, and have personally agonized over the ADN vs. BSN issue. There is immense pressure to go out and get your BSN (I plan on starting mine the second I complete my current program) because the job market is leaning more and more toward BSN nurses, at least as far as new grads go. I'm aware that some job opportunities will be available to me as an ADN nurse, but not really within the pay grade, hospitals, or specialities that I would prefer -- or consider equitable.

Having compared my curriculum with those of various BSN programs in the area, I see no difference between us in terms of actual clinical skills and time spent in the hospital setting. The RN to BSN bridge that I'll be taking consists of theory and research classes, a dedicated pathophysiology course, and one course focusing specifically on physical assessment.

This requirement that I continue to go to school is one that I accept, and I am actually pretty fond of school/plan on continuing my studies beyond the BSN level. I do consider the entry point somewhat unfair to nontraditional or less advantaged students (like myself) who have eked out their degrees utilizing quite a lot of grit, against financial and personal odds. I don't really see this changing at all, but if you're listening, maybe consider that ADN nurses should be recognized as capable and hard workers and at the very least given a shot.