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?

[NotYourMamasRN]

I think for the relevance and growth of nursing as both a profession and academic discipline, growth toward more BSN will be necessary. Nursing has been around forever, but as far as an actual profession built on a system of knowledge, research, and theory it is in it's infancy. For the profession to have a better standing and delineation against other disciplines, I think the move to BSN is of utmost importance.

[NutmeggeRN, BSN]

meanmaryjean said:

There. Is. NO. Nursing. Shortage.

THANK YOU

[BostonFNP, APRN]

LadyFree28 said:

I am interested.

There was good data somewhere on the educational path broken down by initial degree but I can't remember where it was, will have to look for it, and it actually may be very outdated given the recent changes (but perhaps we'd want data from 2003 and earlier when the study was done).

As an estimate, this past year:

"AACN survey found that 111,634 students graduated from baccalaureate programs last year, including 63,857 students from entry-level programs and 47,777 students from baccalaureate degree completion programs."

[NursesRmofun, ASN, RN]

I also thought the title was misleading for the "grab"...but - anyway- I am not going to get my BSN or MSN. I am just too long at the fair for it...personally....can't wait to retire...even if that is just a year or two before I "go home"! Gota see the humor in that....I could also retire AFTER I go home! LOL

[Boomer MS, RN]

BostonFNP said:

I am always surprised to see that there are a significant number of nurses that consider the increase in the overall education level of the profession rising as a bad thing. After the 1954 white paper from the ANA there was never sufficient momentum for nursing, as a profession, to transition to a bachelor-entry. The result is half a decade later there is a surplus of nurses allowing the market to begin to dictate the educational levels, and to not only selective hire bachelor-prepared nurses but also push out experienced nurses at the higher end of the pay scale. This has fostered a ADN vs BSN fight that is now made even worse by outcomes data, used to pit one against the other.

The truth is that what these studies show is that nurses as lifetime learners make better nurses. If you are a great nurse with a diploma and you continue your education you should be a better nurse with a bachelors or a masters; it doens't mean you are inherently a worse nurse than every other nurse with a higher degree than you.

And on top of all this, we now have these ripoff programs that are simply taking more to stamp a bachelors diploma so nurses can keep their jobs rather than truly educating; that's not going to maintain the same outcome data.

Well articulated. I could not agree more. When I graduated in 1970 with a BSN, there was talk of having two levels of nurses going forward: the "technical" (ADN) and the "professional" (BSN). I cringed at this then as I saw this setting up a competition, even a resentment, if you will, between the the two types of educated nurses. And today there is still that resentment by some. At that time, diploma programs were being phased so were not considered in that prediction. During my career, I never looked down on ADN prepared nurses and worked along side them with pride. What continues to surprise me is the antagonism toward nurses being prepared at the BSN entry level. Every other profession in this country requires a graduate degree for practice. Why has nursing not followed, at least for a BSN? One answer is that with major nursing shortages over the years, the ADN programs helped ease that shortage. When I look at what is happening in other professions, i wonder why isn't nursing following suit? In many ways, nursing is still stuck in a rut. I wish we could focus our energies on battling corporate healthcare to improve conditions instead of fighting among ourselves about furthering our education. It's a travesty that we are still allowing the market to dictate our education level.

[Kristiernbsn]

I don't know why you use headlines that are divisive and start the education argument all over again. We're all nurses -- LPNs too!! We all make a contribution to our patients. Yes, there's an initiative to make 80% of nurses BSNs by 2020, and many hospitals are requiring nurses to get their BSN. I'm getting my BSN right now, but I know how much experience counts and when we're at the bedside, who cares what degree you have?

[NursesRmofun, ASN, RN]

ICUman said:

I feel the thread title is misleading…suggesting it is a competition, when it is not. These nurses are not neck and neck. ADN and BSN nurses work together as a team and are good at it, at least in my hospital they do.

As for the mortality reduction from BSN provided care, it puzzles me how so many fluff courses on theory (as frequently published on this site), can supposedly save more lives than ADN nurses. Hopsitals are more concerned with getting that shiny magnet status, and looking good to the public, than they are with reducing mortality. Otherwise, BSN would have been mandated long ago.

Nonetheless, I do feel a BSN is necessary to remain competitive in the acute care job market and the squeeze will get even tighter with time. BSN also provides options for graduate school, so there is benefit to patient and professional.

Excellent post! I have been sickened lately by all the paperwork/checks for that shiney magnet status--- and they don't care how it gets done (except don't get OT doing it) but they need it to get their criteria for the magnet status. ACKKK! Makes me want to head for the door a little more than all the other stuff I go through...

[2mint]

BostonFNP said:

The...landmark Aiken 2003 study...

I posted this before, but just want to break down the math portion:

"These associations imply that patients in hospitals in which 60% of

nurses had bachelor's degrees and nurses cared for an average of six patients would have almost

30% lower mortality than patients in hospitals in which only 30% of nurses had bachelor's degrees

and nurses cared for an average of eight patients."

Let's look at the numbers:

Nurse BSN caring for 6 patients has a 30% lower mortality rate outcome than

Nurse ASN caring for 8 patients.

Math: 8 divided by 6 = 1.333

Translation: Nurse BSN taking on 33.3% less patient load (6 vs. ? has a 30% lower mortality rate outcome.

hmmm...what happens to that other 3.3%....

[Susie2310]

I think there are some other things to consider. An observation: A significant number of states don't require ANY continuing education for license renewal, while some states require 30 continuing education contact hours in a two year period. Nurses who are certified in a specialty may take 100 continuing education contact hours over a four year period. Surely this wide variety in amounts of continuing education taken by nurses contributes to the quality of nursing care delivered. I have not seen this addressed by people who wish to improve patient outcomes through more nursing education. It appears that raising the formal educational level of nurses is the prime objective for some.

Some people have been quite candid about their desires to "advance the profession by making the BSN the educational level for entry into practice." A number of nurses with higher degrees, including some APN's, wish to raise the educational levels for the profession as they perceive this will increase their credibility as health care providers and will also limit entry to the profession, providing increased job security and improved salaries (supply and demand). Keeping people enrolled in courses to obtain a BSN is necessary for a number of reasons.

[Here.I.Stand, BSN, RN]

Dogen said:

I like to stress that studies that compare BSN and ADN nurses are typically correlational, not true experiments

Let's see...I took ear training. Give me a piece of staff paper and I can notate all the gadgets' alarm songs! My Arthurian lit class taught me all about courtly love, which can be applicable to family dynamics! Granted I took those classes before I got my ADN. Let's see...

Geography taught me about urban heat islands...heat is definitely a bad thing for TBI pts. Oh wait, I could already run the Alsius. Oh, wait!! I know all about Qi and the hospital room!!! Does that mean less of my patients die now? No?

(Sorry...slept 3 hrs last night. Feeling a bit punchy.)

[Guest957596]

kristier said:

I don't know why you use headlines that are divisive and start the education argument all over again. We're all nurses -- LPNs too!! We all make a contribution to our patients. Yes, there's an initiative to make 80% of nurses BSNs by 2020, and many hospitals are requiring nurses to get their BSN. I'm getting my BSN right now, but I know how much experience counts and when we're at the bedside, who cares what degree you have?

Bravo!

[Buyer beware, BSN]

In 1965, the American Nurses Association promulgated a position paper that would require that within 10 years the BSN would be the minimun academic requirement for entry into the profession. Why didn't this happen you may ask? Why in 51 years did this not happen?

I will not bore you with the details except to say: easier to spew them out to sell them out to the lowest bidder.

No offense intended to the ADNs and Diploma nurses or LPN/LVNs who often train the new BSN graduates. To them I am in their debt.