BSN is a joke

MunoRN, RN · Oct 18, 2017

The studies that exist indicate BSN nurses get better outcomes. So unless someone can produce a study that indicates that is not true, there is not point in debating this. Nursing is a profession. Professions require an bachelor's degree, at a minimum.

Do you believe studies that reflect programs from 20 years are equally accurate now? What are you basing that on? The bigger question is how would you change the current system and process for becoming an RN? I agree that this seems pretty straightforward at first, but it's a bit more complicated that you seem to think it is.

CCs can't offer BSNs because CCs, by definition, are 2 year institutions.

There are actually a number of CCs that grant BSN degrees.

Finally, employers can require whatever training and hiring standards they wish. So suck it up. ADN RNs who don't want a BSN can get jobs where a BSN is not required. Otherwise, just put on your big girl or big boy pants and be a professional. I'm an NP and if the DNP becomes a requirement, I'll suck it up and get a DNP.
These discussions about not wanting a BSN and that BSNs are worthless make me cringe in shame for the nursing profession.

There certainly is a group that just doesn't want to get a BSN, but I think the larger argument is whether nursing would benefit from making BSN the entry to practice, which it pretty clearly would not. To reduce the quality of nursing education and the profession just to rid us of ADNs would be a shame for the nursing profession.

Valcorie34, BSN, MSN, RN · Oct 18, 2017

I am getting my BSN online and attending GWO George Washington University. Many of the classmates from ny ADN program are sayign similaar things about thier classes. Especially people attending WGU washington governors and move at your own pace classes. But I am really finding the curiculum in my program relevant. I see myself using a great deal of it. Things like learning how manage quality improvment, root cause analysis ect. Consepts are broken down to a level that relates to floor nurses and relevant managment topics like Med errors, vulnerable populations in your area, understading health care policies and how it relates to your specialy ect. I have been very happy with it.

allnurses Guide · Oct 18, 2017

The BSN push comes from nursing academia - this has already been discussed on this thread.

Actually the majority of the pressure is coming from employers not academia.

Retrospective patient questionnaires about aspects of the care the patient received from the nurse during their hospitalization?

FWIW this is not at all how they measured outcomes in any of the major studies.

I would like to see these topics addressed by those charged with educating nursing students - a discussion of what needs to change in ADN-BSN programs to provide a better experience for already licensed RN's, and what needs to change in nursing programs to better prepare students to practice at a basic level when they start working.

I think most of us agree that there are some useless ADN-BSN bridge programs and these programs need to be addressed; and we aren't sure even quality programs will change the outcomes data. But those programs are filling need right now because employers are requiring it.

allnurses Guide · Oct 18, 2017

I'm not sure that second career ADNs are necessarily falsely increasing the outcome data for ADNs since they are a core part of the ADN group. And I agree that to lose those second career nurses and the other beneficial demographics that ADN programs bring would not benefit nursing.

Second degree ADNs are not really ADNs as they are bachelor-prepared RNs just like BSNs; to seperate them out would shed some light on whether it is the liberal arts education or the specific BSN cirriculum that is affecting outcomes. It would be a great study to do.

Susie2310 · Oct 18, 2017

FWIW this is not at all how they measured outcomes in any of the major studies.

Then tell us what specific outcomes were measured, and how, specifically, they were measured.

elkpark · Oct 18, 2017

Then tell us what specific outcomes were measured, and how, specifically, they were measured.

Or you could read the studies yourself and find out ...

Susie2310 · Oct 18, 2017

Or you could read the studies yourself and find out ...

Is it possible that as a former nursing instructor/faculty member you feel a little defensive? Really, this is a serious discussion. I haven't seen you provide any answers to how nursing education should be improved so that students bridging to BSN have a better experience and so students are better prepared clinically to function at a basic level clinically in their first jobs.

So yes, I ask again, of Bostonfnp, to tell us all the specific outcomes measured, and how, specifically they were measured, so that everyone on this forum can benefit from this information. Nursing academia, and apparently, according to Bostonfnp, employers, are pushing the BSN, and this community is comprised of nurses, students, and pre-nursing students, amongst other people. Why not share information that you believe would be beneficial to this community?

elkpark · Oct 18, 2017

Is it possible that as a former nursing instructor/faculty member you feel a little defensive? Really, this is a serious discussion. I haven't seen you provide any answers to how nursing education should be improved so that students bridging to BSN have a better experience and so students are better prepared clinically to function at a basic level clinically in their first jobs.
So yes, I ask again, of Bostonfnp, to tell us all the specific outcomes measured, and how, specifically they were measured, so that everyone on this forum can benefit from this information. Nursing academia, and apparently, according to Bostonfnp, employers, are pushing the BSN, and this community is comprised of nurses, students, and pre-nursing students, amongst other people. Why not share information that you believe would be beneficial to this community?

A) I don't feel defensive at all. I have no dog in this fight.

B) I was unaware I was under any obligation to provide answers on "how nursing education should be improved." The suggestions that I do have would never fly with the larger nursing academic community, so I just stay out the whole matter these days and keep my mouth shut.

C) I am sure that if BostonFNP made the mistake of falling into your trap and attempting to explain the methodology of the various relevant studies, you would respond with further objections and disputations. You've made your own bias very clear. Hence, my suggestion that you can easily get that information yourself by reading the studies yourself. Besides, what serious person interested in evaluating the studies would be satisfied with a description of the studies by someone else whose motives you suspect in the first place, rather than going directly to the source??

Susie2310 · Oct 18, 2017

C) I am sure that if BostonFNP made the mistake of falling into your trap and attempting to explain the methodology of the various relevant studies, you would respond with further objections and disputations. You've made your own bias very clear. Hence, my suggestion that you can easily get that information yourself by reading the studies yourself. Besides, what serious person interested in evaluating the studies would be satisfied with a description of the studies by someone else whose motives you suspect in the first place, rather than going directly to the source??

I'm sorry you are so suspicious of my motives, but I assure you my question is genuine and not intended as a trap. You provide some insight into how you think though.

Yes, I can get the information myself, but I'm asking Bostonfnp, as a guide on this forum and presumably a member of nursing academia, as you have been or are, to provide this information for everyone on the forum. That is not a trick question. This whole discussion has been about the BSN, and some posters believe the BSN is a superior degree because of certain outcomes. However these outcomes are unspecified and the manner in which they were obtained is unspecified. Why talk about outcomes if you are not prepared to divulge what they are and how they were obtained? Why try to push the BSN without providing this information? This is an opportunity to educate the community on this forum, and an opportunity for future discussion.

mmc51264, BSN, MSN, RN · Oct 19, 2017

I was one of those people who thought having to get a BSN was stupid. I have a BS in Biology and thought that should be enough. When I started my journey, the program where I took my first semester was the nightmare everyone talks about: papers after papers and I swear they did not read them, just looked at APA and that was it. hardly any of the instructors were doctorate-level, even the director of the program was not qualified, in my opinion, with a BSN and a MPH. Really????

I changed programs to one where all instructors were Ph.D level. The program was a 180 degree change from the first one. I loved it! It built upon what I had learned and experienced (I waited almost 2 years after getting my ADN and first job). It had context. The activities did include papers, but that was a small part of it. I valued that program and now an all for the extra education.

I have also had first-hand experience with how differently prepared some of the ADN nurses versus the BSN nurses are. ADN nurses have MUCH more hands on. I am a preceptor now and it can be quite shocking how little hands-on experience some new grads have had.

I think until some of these RN-BSN programs are more standardized, there is going to be a wide variety of experiences.

allnurses Guide · Oct 19, 2017

Is it just me or does this whole thing sounds just like the anti-vax pseudo-scientist crowd? The studies are readily available to everyone who "does their own research" but funny enough they don't come up when googling the answer you are looking for. The internet is ripe with confirmation bias.

So yes, I ask again, of Bostonfnp, to tell us all the specific outcomes measured, and how, specifically they were measured, so that everyone on this forum can benefit from this information.

Do you want me to summarize the studies for you? They make abstracts for that. I am happy, for the "good of all", to summarize them for you and the readers that are too lazy or too poorly equipped to research the studies on their own. I would be happy to provide full-text to anyone that requests it, if they don't have access. Here are just a few of the Aiken studies:

Aiken et al (2003), JAMA: "Discharge abstracts for the universe of 232â€“342 patients aged 20 to 85 years who underwent general surgical, orthopedic, or vascular procedures from April 1, 1998, to November 30, 1999, in the 168 nonfederal hospitals were obtained from the Pennsylvania Health Care Cost Containment Council, which checks the data for completeness and quality."

Aiken et al (2011), Med Care: 30-day inpatient mortality and failure to rescue across 665 adult acute care general hospitals in California (n = 271), Pennsylvania (n = 153), Florida (n = 168) and New Jersey (n = 73). These are four of the nation's largest states, and account for over 20% of annual hospitalizations. The hospitals included in our sample represent 86% of all general acute hospitals in the four states and account for over 90% of all adult general, vascular, and orthopedic surgical patient discharges in those states.

Aiken et al (2014), Med Care: In-hospital all-cause mortality and same-hospital all-cause 30-day readmission were coded as dichotomous variables with nonoccurrence as the reference category. The sample was derived from adult nonpsychiatric inpatient discharges from an urban Magnet-designated academic medical center.Our data extraction criteria included all discharges from medical-surgical units of adult (18 and older) patients during a 7-month period between June 1, 2011 and December 31, 2011 and their direct care nurses, resulting in a linked sample of n = 10,310 patients and n = 1477 nurses.

Nursing academia, and apparently, according to Bostonfnp, employers, are pushing the BSN, and this community is comprised of nurses, students, and pre-nursing students, amongst other people. Why not share information that you believe would be beneficial to this community?

I give the community more credit than you do, but as above, I am, happy to help guide that, an more importantly provide primary sources to be reviewed critically by every individual.

Yes, I can get the information myself, but I'm asking Bostonfnp, as a guide on this forum and presumably a member of nursing academia, as you have been or are, to provide this information for everyone on the forum. That is not a trick question. This whole discussion has been about the BSN, and some posters believe the BSN is a superior degree because of certain outcomes. However these outcomes are unspecified and the manner in which they were obtained is unspecified. Why talk about outcomes if you are not prepared to divulge what they are and how they were obtained? Why try to push the BSN without providing this information? This is an opportunity to educate the community on this forum, and an opportunity for future discussion.

I am not a member of "nursing academia" as you mean it. I hold adjunct faculty appointments at two schools, one nursing and one medical, as well at clinical faculty appointments at both as well, at the doctoral and graduate level only. I have zero interaction or involvement with pre-bac students.

The data is the data, there is not "believe this or that". I have readily posted several times on this thread alone that the data shows better outcome for BSN nurses but in my read offers no justification for those outcomes, nor were the studies powered to evaluate that information.

Again I am not pushing the BSN, employers are. Do you seriously disagree with the fact the majority of this recent pressure comes from employers?

shibaowner, MSN, RN, NP · Oct 19, 2017

The NCLEX is the professional licensing exam for RN's. There is no two tiered system; one for BSN prepared graduates and one for ADN/Diploma prepared nurses. State boards of nursing do not make a distinction that BSN prepared nurses are better prepared to practice nursing. The BSN push comes from nursing academia - this has already been discussed on this thread.
From my own experience (I apologize for not being able to provide a study as I number just one individual) during my last semester of my ADN-BSN bridge program, at a respected bricks and mortar state university, I heard generic BSN students in their final semester say that they had received hardly any clinical training and didn't feel prepared to be nurses. This was evident in the practicum that we participated in together. I am not generalizing this to all BSN programs, but I have heard these comments often enough during the 20+ years since I have been licensed that even though there is apparently no study to "demonstrate" that ADN students are better prepared clinically than BSN students, I have to take these comments into account. We don't need a study to tell us everything; contrary to what some people appear to believe, we just need to be intelligent and observant.
We have qualitative studies that purport to show that BSN prepared nurses provide care that yields superior patient outcomes versus ADN prepared nurses. The studies are not without flaws, yet we are urged to accept them without question. Also, qualitiative studies do not provide a level of evidence close to that of Randomized Control Studies. Anyone who disagrees is free to research this for themselves. What outcomes are we talking about? If clinical outcomes, what outcomes precisely? Morbidity and mortality - no. Retrospective patient questionnaires about aspects of the care the patient received from the nurse during their hospitalization?
The OP and other people on this thread commented that their experiences of BSN education after they are already a licensed RN fell short of their expectations, and the topic has been brought up that new graduate nurses need more clinical preparation in nursing school to be able to function at a basic level clinically when entering the workplace. I would like to see these topics addressed by those charged with educating nursing students - a discussion of what needs to change in ADN-BSN programs to provide a better experience for already licensed RN's, and what needs to change in nursing programs to better prepare students to practice at a basic level when they start working.

1. You have attacked every single study presented, yet all you provide is anecdotal observation, which is not even evidence. You also demonstrate a lack of understanding of levels of evidence and statistical significance. Qualitative studies, if well-designed, are good evidence. Can you tell us how you would design a study to compare ADN vs BSN nurses? You can give us a one page summary.

2. In order for a nursing school to be accredited, they must meet certain requirements. Clinical hours are one of the requirements. So, do ADN programs provide more clinical hours? If so, can you please provide evidence of this? It should be easy for you to research the curriculum and clinical hours of some ADN schools vs BSN schools.

3. I provided several studies and one of them indicated patients were less likely to die with BSN nurses. I think that's about as significant as it gets.

4. I see no reason for this resistance to ADN to RN bridge programs. These programs are part-time and designed for people working full-time. I also presented a curriculum from SDSU that seems full of interesting and useful classes and clinical. There are probably crappy online-only programs out there, but no one is forcing people to go to those. Given that most RNs seem to work flexible hours of three 12 hour shifts, going to school part time and taking one class per semester should not be a hardship. Here's an anecdote: I met a young woman, 23 years old with 6 kids by different fathers, who was working as a CNA and going to school part time to earn her ADN. Her goal was to earn her BSN and then become an NP after that. She wanted to set a good example for her kids. If she can do it, anyone can do it!

5. You are free to advocate for ADN nurses and not having a BSN requirement. Let us know how that works for you when you talk to employers, the ANA, and so forth.