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?

[LadyFree28, BSN, LPN, RN]

Boomer MS, RN said:

Oh dear.

Indeed.

[Boomer MS, RN]

The employment and pay is no different for RN with differing levels of education.

This is not true everywhere. One facility where I worked gave a differential for a BSN and a MSN. The hospital, however, did have a strong union. What a union contract offers can change each time it is renegotiated.

[BostonFNP, APRN]

Boomer MS, RN said:

The employment and pay is no different for RN with differing levels of education.

This is not true everywhere. One facility where I worked gave a differential for a BSN and a MSN. The hospital, however, did have a strong union. What a union contract offers can change each time it is renegotiated.

Based on the number from the ADVANCE 2015 salary survey there is a pretty significant difference in salary by degree. That doesn't mean that job X pays a BSN-RN more than a non-BSN-RN but it does show that in aggregate those with a BSN-RN make more money.

[Boomer MS, RN]

BostonFNP said:

Based on the number from the ADVANCE 2015 salary survey there is a pretty significant difference in salary by degree. That doesn't mean that job X pays a BSN-RN more than a non-BSN-RN but it does show that in aggregate those with a BSN-RN make more money.

Again, this was negotiated by a strong union. Anecdotal at best.

[Dogen]

Boomer MS, RN said:

Again, this was negotiated by a strong union. Anecdotal at best.

Only 25% of the nurses in the Advance survey were at unionized hospitals. As a national survey with respondents from every region of the country anecdotal doesn't seem like the appropriate label.

[TriciaJ, RN]

Pangea Reunited said:

ASN is enough for me as I'm content to go traipsing about causing sentinel events. I've even considered forgetting some of what I've already been taught.

Sometimes I even go around causing autism.

[Boomer MS, RN]

Dogen said:

Only 25% of the nurses in the Advance survey were at unionized hospitals. As a national survey with respondents from every region of the country anecdotal doesn't seem like the appropriate label.[/quote

To clarify, my comment was anecdotal. I was not referring to the national survey, only to the contract at my hospital at the time.

[Dogen]

Boomer MS, RN said:

To clarify, my comment was anecdotal. I was not referring to the national survey, only to the contract at my hospital at the time.

Ah, my apologies. I'll stand corrected! ?

[BuckyBadgerRN, ASN, RN]

Sigh. Another drinker of the nursing shortage kool-aid

Itsybit56 said:

Nursing boards for an ADN/ASN are exactly the same for a BSN. I am very concerned with nursing care related to shortage. We already have a nurse shortage nation wide. I feel hospitals only wanting BSN nurses is going to increase this shortage. The focus is wrong. We need to utilize all our nurses MSN, BSN, ASn/ADN and LPN to decrease the nursing shortage and that would improve patient outcomes and reduce deaths.

[macawake, MSN]

2mint said:

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%....

Cute joke ? crappy math

Eight is 33.3% more than six ... but .....

six is 25% less than eight. (6 divided by 8 = 0.75).

Meaning that ...

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

(However the ADN nurse has a 33.3% larger load than the BSN).

Since you're discussing the reduced mortality rate (of 30%) when the patient load is decreased you need to look at 8 patients --> 6 patients per nurse, i.e. a 25% reduction and compare those two numbers against each other.

So what happened to the other 3.3%? They were never there in the first place..

[missmollie, ADN, BSN, RN]

If you had a choice between a nurse with 1 year experience and an ADN, a new nurse with a BSN, or a LPN with 10 years experience, who would you want taking care of you? Any nurse with more experience is going to do better. When does it even out? At year 3, year 4?

Shall we require that our BSN educated nurses have at least x amount of years in customer service? Think of how much better that would be for press ganey scores! If they were really successful, they would've been at least a lower level manager at a restaurant. That's the ticket, that's what will make nurses better!

Maybe, we should only accept Doctor's who finish in the top 90th percentile of their class. I don't want someone with a "C" average taking care of me, I don't care how good he is.

The argument is not valid.

[BostonFNP, APRN]

missmollie said:

If you had a choice between a nurse with 1 year experience and an ADN, a new nurse with a BSN, or a LPN with 10 years experience, who would you want taking care of you? Any nurse with more experience is going to do better. When does it even out? At year 3, year 4?

Shall we require that our BSN educated nurses have at least x amount of years in customer service? Think of how much better that would be for press ganey scores! If they were really successful, they would've been at least a lower level manager at a restaurant. That's the ticket, that's what will make nurses better!

Maybe, we should only accept Doctor's who finish in the top 90th percentile of their class. I don't want someone with a "C" average taking care of me, I don't care how good he is.

The argument is not valid.

I am not sure what argument you you consider invalid. Education and experience are not mutually exclusive, and research has demonstrated that both education and experience influence patient outcomes. The waters are muddied even further if you consider exactly what experience is being measured, as not all is equally relevant to the role being evaluated. There is a great deal of individual variability as well and none of this data can be applied to compare individual nurses.