BSN to practice ethical dilemma - where do you stand?

[sowelu88]

This debate is decades old and unresolved still. I would love any perspectives voiced as to why you are FOR or AGAINST having a BSN required in order to enter practice as an RN.

For the record I am against it.... feeling that we should be granted a grace period of ten years to aquire a BSN if we want to with some sort of reasonable incentive to do so. The wage increase is not enough to make the cost of schooling make sense for at least 10-15 years and we are in a country where grants and scholarships are hard work too. The lag time of implementing this would worsen the nursing shortages too and some of the best nurses I know are not highly "degreed"...

What are your feelings on this?

[hiddencatRN, BSN, RN]

I think one of the things the ANA could be doing is working on more educational grants for nursing education, particularly for LPNs and ADNs to afford BSN programs.

I couldn't agree more- loan forgiveness is all well and good, but more scholarships and grants for the costs up-front are definitely needed.

[jjjoy, LPN]

Interesting, huh? One ASN program requires less than 70 credit hours and another over 100! (That's including nursing classes and gen ed and not 'remedial' courses needed to qualify for required coursework).

Bachelor's degrees generally require around 64 lower division credits and 64 upper division credits (based on an average of 16 units/semester which is usually considered full-time) so that's over 120 credit hours.

Since the ADN qualifies one to be an RN and for all types of clinical work that require an RN, the clinical instruction (nursing, pathophys, pharm, etc) of ADN and BSN programs SHOULD be equivalent, shouldn't they? So what IS the extra that a BSN can provide to a practicing nurse? Currently, it's the 'well-roundedness' that any bachelor's degree purports to provide as well as perhaps more emphasis on non-bedside nursing roles such as public health nursing, school nursing, research nursing, etc. In regard to well-roundedness, any bachelor's degree should suffice. In regard to the 'extra' nursing content, it's mostly not relevant to a bedside nurse.

The kicker to me is that so many say BSN is for those who want to pursue administration. I know my program had one 3 unit course that lumped all legal/administrative/ethical nursing issues together. That doesn't exactly prepare me to be an administrator. Even for other non-bedside roles, it was one course on community health (home health, public health, child health, etc), one course on research... again, more like "intro to other nursing roles" as opposed to actually training us for such roles.

[txspadequeenRN, BSN, RN]

:yeahthat:

. I think one of the things the ANA could be doing is working on more educational grants for nursing education, particularly for LPNs and ADNs to afford BSN programs.

[chaxanmom]

:yeahthat:

I couldn't agree more- loan forgiveness is all well and good, but more scholarships and grants for the costs up-front are definitely needed.

Well there we go, we have ourselves an issue to lobby! I live in the suburbs of D.C. so come on over and let's go to Washington!

[MOMTOFIVE]

The time spent in school does not really matter, does it? It is the degree earned. A nurse spending 5 years on an ADN or 6 years on a BSN does not address the issue of advancing the profession. I completely understand the hardship of a BSN program as a non-trad student (37, married, 5 kids, 1hour 20 minute commute, single income family, $24,000 at a 4 year vs.$8,000 at a CC). We are getting swallowed by the ADN vs. BSN, my mamma can beat up your mamma argument. The question is do we want our profession to receive the recognition that it deserves? To do this we need to have a BSN for entry to the profession, plain and simple.

I had the opportunity to listen to Dr. Diane Hamilton of Western Michigan University. Her area of expertise is in the history of nursing. She explained that in nursing we have those who practice the "profession" of nursing and those that practice the "craft" of nursing. In both categories ADNs and BSN exist. We need to stop worrying about the amount of time spent preparing and worry about how we practice, are we happy just as we are or do we want to advance the profession?

[MB37]

I can't link the articles, unfortunately, since you have to attend my school and have a password to get access to the full text. However, here is some genuine research on the issue for anyone who is interested. Look them up in your school's library or website. Like I said, I wrote a paper on whether BSN-prepared nurses provide better patient care, and I had no idea going in. A couple of these articles didn't find significant results, but the ones that did found that BSN nurses prevented more deaths. I didn't reread all the articles before posting, so there is a possibility that a couple of them deal more with nurse staffing in general. I'm not sure, so I included all of them.

Aiken, L. H., Clarke, S. P., Cheung, R. B, Sloane, D. M., & Silber, J. H. (2003) Educational levels of surgical nurses and surgical patient mortality [Electronic version]. The Journal of the American Medical Association, 290(12), 1617-1623.

Blegen, M. A., Vaughn, T. E., & Goode, C. J. (2001). Nurse experience and education: Effect on quality of care [Electronic version]. Journal of Nursing Administration, 31(1), 33-39.

Estabrooks, C. A., Midodzi, W. K., Cummings, G. G., Ricker, K. L., & Giovannetti, P. (2005). The impact of hospital nursing characteristics on 30-day mortality [Electronic version]. Nursing Research, 54(2), 74-84.

Heinz, D. (2004). Hospital nurse staffing and patient outcomes: A review of current literature [Electronic version]. Dimensions of Critical Care Nursing, 23(1), 44-50.

Kidder, M. M., & Cornelius, P. B. (2006). Licensure is not synonymous with professionalism: It’s time to stop the hypocrisy [Electronic version]. Nurse Educator, 31(1), 15-19.

Lang, T. A., Hodge, M., Olson, V., Romano, P. S., & Kravitz, R. L. (2004). Nurse-Patient Ratios: A systematic review of the effects of nurse staffing on patient, employee, and hospital outcomes [Electronic version]. The Journal of Nursing Administration, 34(7/8), 326-337.

Needleman, J., Buerhaus, P. I., Stewart, M., Zelevinsky, K., & Mattke, S. (2006). Nurse staffing in hospitals: Is there a business care for quality? [Electronic version]. Health Affairs, 25(1), 204-211.

O’Brien-Pallas, L., Doran, D. I., Murray, M., Cockerill, R., Sidani, S., Laurie-Shaw, B., et al. (2002). Evaluation of a client care delivery model, part 2: Variability in client outcomes in community home nursing [Electronic version]. Nursing Economic$, 20(1), 13-21, 36.

Rothberg, M. B., Abraham, I., Lindenauer, P. K., & Rose, D. N. (2005). Improving nurse-to-patient staffing ratios as a cost-effective safety intervention [Electronic version]. Medical Care, 43(8), 785-791.

Sasichay-Akkadechanunt, T., Scalzi, C. C., & Jawad, A. F. (2003). The relationship between nurse staffing and patient outcomes [Electronic version]. The Journal of Nursing Administration, 33(9), 478-485.

Tourangeau, A. E., Cranley, L. A., & Jeffs, L. (2006). Impact of nursing on hospital patient mortality: A focused review and related policy implications [Electronic version]. Quality and Safety in Health Care, 15, 4-8.

Tourangeau, A. E., Doran, D. M., Hall, L. M., O’Brien-Pallas, L., Pringle, D., Tu, J. V. et al. (2007). Impact of hospital nursing care on 30-day mortality for acute medical patients [Electronic version]. Journal of Advanced Nursing, 57(1), 32-44.

[chaxanmom]

The time spent in school does not really matter, does it? It is the degree earned. A nurse spending 5 years on an ADN or 6 years on a BSN does not address the issue of advancing the profession. I completely understand the hardship of a BSN program as a non-trad student (37, married, 5 kids, 1hour 20 minute commute, single income family, $24,000 at a 4 year vs.$8,000 at a CC). We are getting swallowed by the ADN vs. BSN, my mamma can beat up your mamma argument. The question is do we want our profession to receive the recognition that it deserves? To do this we need to have a BSN for entry to the profession, plain and simple.

I had the opportunity to listen to Dr. Diane Hamilton of Western Michigan University. Her area of expertise is in the history of nursing. She explained that in nursing we have those who practice the "profession" of nursing and those that practice the "craft" of nursing. In both categories ADNs and BSN exist. We need to stop worrying about the amount of time spent preparing and worry about how we practice, are we happy just as we are or do we want to advance the profession?

:yeahthat::heartbeat:bowingpur

[Buttercupviking]

Ok, how bout I throw this into the mix, What about someone who has a BS in Physiology and Neurobiology coming back to get an ADN?