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BSN vs ADN

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classicdame, MSN, EdD

Specializes in Hospital Education Coordinator.

it may depend on the program some, but depends on the individual nurse a lot. Texas requires the same amount of clinical hours for all the programs, but some elect to do more than is required. However, not all students are equal either. It is not good to start labeling schools or people as someone will always come along to break the "rule"

I had a four-year degree in a social science when I decided to attend nursing school, so I would not have needed basic educational courses to get a BSN. What determined my choice of school was that I was locked into a Monday-Friday 8-5 job while I was attending school, and it was financially impossible for me to stop working. The BSN programs in my area expected me to be available basically all day and part of the evening. An ADN program in my area started a pilot program for people in my situation, in which the classes and most of the clinicals were conducted in the evening and on weekends. It was the only practical way for me to get my RN.

As far as clinical training (and bear in mind I completed nursing school over 15 years ago) it seemed that the BSN students I encountered in the hospitals were not as well versed in the hands-on skills. A BSN student who was about to graduate asked me (during my second semester) what supplies she would need to start an IV. In my last clinical rotation I was on an oncology unit. On my first day on the floor, one of the nurses walked over to me and looked at the patch on my uniform sleeve. She said "Thank God. I thought you were from (the most prominent BSN program in my area)."

As far as the professionalism aspect, it is a fallacy, IMO, that one can only be a professional with a BSN. There are pluses and minuses to both degree paths, and as others have pointed out, you do not complete an ADN in two years. Having been to a four-year university beforehand, I can honestly say that the quality of my instruction in both prerequisite courses and nursing courses compares favorably with the four-year schools I attended. If the ADN is not as "worthy", someone please explain to me why we consistently outperformed the BSN programs in my area in the percentage of students who passed state boards.

There will always be people who want to split the nursing profession into tiers - with themselves at the top. You don't strengthen a profession by excluding most of the people in it.

Yes, there are many good reasons why people pursue ADN degrees. One reason is cost: Six units at the community college I obtained my ADN from are $308 for the spring 2013 semester. Six units at the state university I bridged in to my BSN at are $3584. If you already have a bachelor's degree or for graduate school the fee for six units is $4,217. I have nothing against nursing advancing as a profession, but today college education at universities is becoming increasingly for the more affluent, or at the very least the fully employed in well paying jobs, or those whose families can provide financial support. Yes, I know there are scholarships, and loans, but when I look at the numbers, being saddled with a large amount of debt when nursing jobs are not easy to come by or keep (let alone good nursing jobs), is a questionable move to me. I would not pay these fees today for a BSN. I won't pay them for a graduate degree either. But, everyone's circumstances, career ambitions, ideas and beliefs about education are different, and that is the important point, that we are all different, with different backgrounds, schooling etc. and ADN fits some people. I won't even mention the topic of whether ADN training is clinically superior (we have all read these boards). What is important surely is that the graduate of either program is a good nurse.

llg is correct in that not all schools are created equal. Not only are some ADN prorgams at for-profit schools shorter in duration, but I know one near me that provides 1/2 of the in-hospital clinical experiences that the community college 5 miles away offers. Many of its clinicals are in nursing homes (for med-surg) at a Head Start clinic (for peds), or are similation experiences in the lab.

I encourage prospective students to do their research about programs. Of course you should look at NCLEX pass rates. But also look at retention/attrition rates --- what percentage of the students who start on Day 1 graduate on time? A third thing to consider is where current graduates are working for their first job. What you want to find is the Trifecta --a high pass rate on the NCLEX, nearly everyone who starts the program graduates on time, and they all get the starting jobs that you want to have.

Topaz7

Specializes in Psychiatric- Detox and ECT.

Where I livE and what I've been told is that ADNs are more confident and need less monitoring than BSN nurses. Btw I'm an Lpn so I'm not biased one way or the other, but when I was a caregiver on the floor we had many bsn students in their leadership who had never given any injections during school and the ADNs I saw had a lot more clinical experience already. Also the ADN school preps you for nclex better here with. 99% pass rate whereas the bsn had only 75%(as of earlier this year). It's making me lean more towards completing my ADN first when I go back and going my bsn at done point online.

llg is correct in that not all schools are created equal. Not only are some ADN prorgams at for-profit schools shorter in duration, but I know one near me that provides 1/2 of the in-hospital clinical experiences that the community college 5 miles away offers. Many of its clinicals are in nursing homes (for med-surg) at a Head Start clinic (for peds), or are similation experiences in the lab.

I encourage prospective students to do their research about programs. Of course you should look at NCLEX pass rates. But also look at retention/attrition rates --- what percentage of the students who start on Day 1 graduate on time? A third thing to consider is where current graduates are working for their first job. What you want to find is the Trifecta --a high pass rate on the NCLEX, nearly everyone who starts the program graduates on time, and they all get the starting jobs that you want to have.

Clinicals at nursing homes or other non-hospital but still a healthcare facility happened back in the 1980's and has only grown, at least here in the NYC area. For one thing with hospital stays being cut to the bare bone duration by what Medicare/Medicaid and insurance companies will pay patients are discharged to LTC,nursing homes, rehabilitation, etc to receive skilled or nursing care that would would have been part of their hospital duration. There is nothing wrong or evil in taking clinicals as such locations by nature. Long as the instructors are on top of their game, the facility supportive and so forth student nurses can and usually do receive the same sort of training equal to hospital.

Whenever we have this debate (which seems to occur as regular as the cycles of the moon), the thing often breaks down into differences between ADN and BSN programs. Have said before and will say it again it is not totally fair to make this comparison, especially when it comes to clinical hours.

By their nature two year (associate) degrees are job training programs with college level content added.The nature and amount of that said content varies by state education laws/rule and mission of the school. However usually most states give leeway for associate degrees to focus more on the job "training" aspect in lieu of hard college level education.

OTHO four year nursing programs are subject to the same rules/laws set down by states for *all* BofS or BofFA candidates. Colleges and universities may also and often do impose their own sets of "core" or other courses mandated of all four year students. There are only so many hours in a day and with only eight semesters to work with something has to give. It would be wonderful to send all nursing students both BSN and ADN for two or more full days of clinicals, the problem for each but more so the former is they cannot be two places at once. Time spent on clinical sites means time must be found elsewhere for not only nursing classes but a good part of the 120 some odd credits required to obtain a BSN.

The obvious solution to this would be to run a BSN program similar to old hospital programs, that is three years in duration with only limited short breaks for the winter holiday and summer. That simply does not fly with most American students as they have grown quite used to long winter, spring and summer time off.

Finally as one has also repeated often, BSN programs in theory were never designed to produce bedside nurses per se. Rather in the grand scheme of things the four year prepared RN was supposed to be more involved in planning, management,evaluation of care along with management and administration of the nursing service. ADNs and UAPs were supposed to provide a bulk of the bedside care. Sadly no one bothered to tell hospitals about this and they have been calling the shots. For the most part a nurse, is a nurse is a nurse.

Just took a quick peek at the NYS website for NCLEX pass rates and yes ADN grads out scored BSNs by a bit over two percent. NYS Nursing:Nursing Programs:RN NCLEX Results: 2008-2012

However the question is what does the NCLEX truly measure and is it any indication of clinical competence. Persons have taken the NCLEX and passed often with *great* scores whilst never having set foot in any healthcare setting for clinical education. Indeed a group of RNs are suing a for profit university system on just those grounds. These RNs attended this program, graduated and passed the NCLEX only to find upon seeking work they lacked any clinical experience. If it wasn't for whomever was doing the hiring of these ladies they would have remained totally ignorant of their situation. What did the school do for "clinicals", according to one news interview the nurses said they were taken to a zoo and other public places.

Does having a Bachelors in a health field and an ADN give you a one up or equal BSN? I mean is the issue just not having a bachelors degree, since I feel the diff BTW the two degrees is the amt of gen ed courses which I've gone thru and completed with my BS. Just wondering

Does having a Bachelors in a health field and an ADN give you a one up or equal BSN? I mean is the issue just not having a bachelors degree, since I feel the diff BTW the two degrees is the amt of gen ed courses which I've gone thru and completed with my BS. Just wondering

A bachelor's degree in a health field and an ADN are not equal to a BSN. The coursework for a BSN includes specific nursing courses. I bridged in to a BSN program after finishing my ADN and obtaining my RN, and had to take a public health class; advanced health assessment class; a nursing research class; do a community health practicum and a preceptorship, plus a few other nursing classes. The public health class requirement as part of the BSN requirements along with already having an RN license meant I was eligible to apply to my state board of nursing for certification as a public health nurse.

I don't remember the number of general education courses I had to take overall, and not knowing how many courses you had to take I can't make any comment on the differences.

I hope this helps to clarify.

Edited by Susie2310

So why is it that MSN programs will accept students with just a RN license (AND) and a BS in a health related field? I've looked into that like Rush University CRNA program that does this, an elite school. It's still somewhat confusing since for instance the public health class you speak of I've taken in undergrad. Not starting a debate just saying.

sapphire18

Specializes in ICU.

Just for the record ... there are some ADN programs that are as short as 15 months long (with no pre-req's). We have one such program in my area. Yes, it's a "for-profit" school.

I'm sorry, but that's disgusting. Really?? Just...wow.

Please let it be known that there are for profit schools that are offering BSN programs like West Coast University; and not just ADN.

Please let it be known that there are for profit schools that are offering BSN programs like West Coast University; and not just ADN.

My bad that came out confusing there are as much for profit schools awarding BSN just as ADN programs

akulahawkRN, ADN, RN, EMT-P

Specializes in Emergency Department. Has 6 years experience.

In regards to Master of Science level Nursing programs:

They are looking for students that have a certain level of academic achievement. As part of their prerequisites, they are probably looking for certain types of coursework that is going to show them that you are able to absorb the information that you will be given. You do not necessarily need management training, public health training, or things like that to succeed in a Masters level program. You are probably going to need some type of research course, statistics course, and the like. That is probably what they are looking for in their students. An RN with that type of preparation will probably do just as well as a BSN, because they've had similar academic preparation that is geared more towards research.

That being said, a Bachelor Science in any field, even healthcare, does not equal a BSN because the BSN coursework typically include some classes that are not included in any other healthcare field.

Personally, I think that it is a folly to take the position that an RN that has a Bachelors of Science in a healthcare field is less capable of incorporating best evidence-based practices into their own practice than a BSN is. After all, many ADN programs are just as academically rigorous as BSN programs, without some of the public health and management coursework that the BSN programs do provide. The program that I was in until recently, is actively looking at petitioning to get their program recognized as a BSN program, that is taught at a junior college. They recognize that they will have to incorporate a little bit of new content that is not currently part of their curriculum, and should they be approved for that change in program status, they will simply add the missing content.

In regards to Master of Science level Nursing programs:

They are looking for students that have a certain level of academic achievement. As part of their prerequisites, they are probably looking for certain types of coursework that is going to show them that you are able to absorb the information that you will be given. You do not necessarily need management training, public health training, or things like that to succeed in a Masters level program. You are probably going to need some type of research course, statistics course, and the like. That is probably what they are looking for in their students. An RN with that type of preparation will probably do just as well as a BSN, because they've had similar academic preparation that is geared more towards research.

That being said, a Bachelor Science in any field, even healthcare, does not equal a BSN because the BSN coursework typically include some classes that are not included in any other healthcare field.

Personally, I think that it is a folly to take the position that an RN that has a Bachelors of Science in a healthcare field is less capable of incorporating best evidence-based practices into their own practice than a BSN is. After all, many ADN programs are just as academically rigorous as BSN programs, without some of the public health and management coursework that the BSN programs do provide. The program that I was in until recently, is actively looking at petitioning to get their program recognized as a BSN program, that is taught at a junior college. They recognize that they will have to incorporate a little bit of new content that is not currently part of their curriculum, and should they be approved for that change in program status, they will simply add the missing content.

Just so you know there is *BIG* drama going on about community/junior colleges being allowed to award BofS degrees. No other than University of Phoenix is leading the charge:

University Of Phoenix Lobbied Against Community College Expansion

So why is it that MSN programs will accept students with just a RN license (AND) and a BS in a health related field? I've looked into that like Rush University CRNA program that does this, an elite school. It's still somewhat confusing since for instance the public health class you speak of I've taken in undergrad. Not starting a debate just saying.

There are all manner and flavor of MSN programs that will take ADN/dipoma RNs to MSN and along the way award a BSN. Others will take those with an undergraduate degree in a non-nursing major and are dual BSN/MSN degrees. In the top tier of such programs would be the famed Columbia University BSN/MSN (ETP) school of nursing. Admissions Frequently Asked Questions

Columbia U has a *very* famous and great nursing education history but for various reasons discontinued their undergraduate program decades ago, in favour of masters and above nursing education. There is no way to obtain a BSN from Columbia without going for the MSN portion as well.

That being said for most of these MSN types of programs they are elite in that only a handful of applicants out of hundreds make the cut. Long story short we're still talking about seeking entry into graduate school and that is never easy, especially for top programs. Here is a bit of Columbia's process:

http://www.cumc.columbia.edu/dept/nursing/admissions/pdf/GRE_ApplicationInformation.pdf

Now matter how "good" a nurse one is if you cannot muster the chops to obtain a good GRE score then your chances of being accepted at Columbia or any other top BSN to MSN etc... program are slim. As another posted stated these programs want to see applicants that can prove via past academic work they are able to handle graduate school.

akulahawkRN, ADN, RN, EMT-P

Specializes in Emergency Department. Has 6 years experience.

Just so you know there is *BIG* drama going on about community/junior colleges being allowed to award BofS degrees. No other than University of Phoenix is leading the charge:

University Of Phoenix Lobbied Against Community College Expansion

I am not at all surprised that there is a big to do with community/junior colleges being allowed to award Bachelor of Science degrees. I am also not at all surprised that University of Phoenix is in fact leading the charge, because it goes against their business model. What they are looking for is to funnel community college students into their online bachelors programs. If a community college is offering a Bachelor of Science degree, that would certainly undercut some of their business.

Personally, I think that junior colleges should be allowed to offer Bachelor of Science degrees to certain select programs, such as nursing. The reason being that public health, statistics, etc. can be offered at the junior college level and those are typically the main differences in coursework between the bachelor of science and the Associates of science degrees in nursing.

In any event, I am certainly surprised that junior colleges are being allowed to offer and award Bachelor of Science Degrees, because I just amazed that they are allowed to do that. When I began going to college, the separation between community college and university level schools was very very clear. Community colleges could only offer and award Associate's Degrees and universities could offer Bachelors Degrees and above.

Just to give the OP an idea of what kind of things we ADN students learn, this has been my experience so far:

I just finished up 2nd semester last week.

Out of 18 weeks we were in the hospital 16. Two days/wk, 5.5 hrs/day.

I've been lucky to get a grand total of 2 foley cath insertions and one NG tube. Both with the instructor present.

For meds we do our 7 rights (we do 7, not 5) with our instructor, she walks in with us to our pt's room, sees that we are safe id'ing our pt then she leaves and we give the meds. If we are giving injections the instructor is always present.

I've lost count of how many insulin and lovenox shots I've given. Vaccines, too.

I have dc'd a few IVs and maybe 2 foleys without supervision. The first 2 or 3 we MUST do with our instructor.

This semster we hung IV bags- no meds- with our instructor present, and we also did tubing changes.

Next semester it is my understanding we will buddy up with a fellow student to do the 7 rights of med admin and we are on our own giving meds. Still our instructor will be pulling meds for us. We'll be doing IV meds as well. That's about all I know about next semester which isn't much.

Anyway, 4th semester students do their preceptorship the last 4 weeks I think- ICBW on the timeline- and if they have > an 80% avg they get to choose their specialty. Otherwise it's med-surg.

This semester we had about 6hrs of lecture/week (after you subtract break time).

So I've been told by the time we graduate we should be capable of carrying out all RN tasks except starting IVs, which we do learn and get tested on but will never actually do in clinical.

Since 1st semester we have lost ~10 people, either bc their grades weren't good enough or they were forced to drop due to poor clinical performance.

My school's NCLEX pass rate has been >97 or 98% for many many years.

Finally, I would like to add that I would have loved to go for a BSN but I didn't for 2 big reasons: #1 Two extra years in school and #2 The cost is prohibitive (and getting worse!).

I have a B.S. already so when I applied to the Nursing program my prereqs were already done!

Best of luck to you!

Edited by Naturalist
time fix

Just to give the OP an idea of what kind of things we ADN students learn, this has been my experience so far:

I just finished up 2nd semester last week.

Out of 18 weeks we were in the hospital 16. Two days/wk, 5.5 hrs/day.

I've been lucky to get a grand total of 2 foley cath insertions and one NG tube. Both with the instructor present.

For meds we do our 7 rights (we do 7, not 5) with our instructor, she walks in with us to our pt's room, sees that we are safe id'ing our pt then she leaves and we give the meds. If we are giving injections the instructor is always present.

I've lost count of how many insulin and lovenox shots I've given. Vaccines, too.

I have dc'd a few IVs and maybe 2 foleys without supervision. The first 2 or 3 we MUST do with our instructor.

This semster we hung IV bags- no meds- with our instructor present, and we also did tubing changes.

Next semester it is my understanding we will buddy up with a fellow student to do the 7 rights of med admin and we are on our own giving meds. Still our instructor will be pulling meds for us. We'll be doing IV meds as well. That's about all I know about next semester which isn't much.

Anyway, 4th semester students do their preceptorship the last 4 weeks I think- ICBW on the timeline- and if they have > an 80% avg they get to choose their specialty. Otherwise it's med-surg.

This semester we had about 6hrs of lecture/week (after you subtract break time).

So I've been told by the time we graduate we should be capable of carrying out all RN tasks except starting IVs, which we do learn and get tested on but will never actually do in clinical.

Since 1st semester we have lost ~10 people, either bc their grades weren't good enough or they were forced to drop due to poor clinical performance.

My school's NCLEX pass rate has been >97 or 98% for many many years.

Finally, I would like to add that I would have loved to go for a BSN but I didn't for 2 big reasons: #1 Two extra years in school and #2 The cost is prohibitive (and getting worse!).

I have a B.S. already so when I applied to the Nursing program my prereqs were already done!

Best of luck to you!

Thank you for showing that ADN programs are just as rigorous n hands on as BSN program. Also your reasons for choosing an ADN program are similiar to mine.

Personally, I think that it is a folly to take the position that an RN that has a Bachelors of Science in a healthcare field is less capable of incorporating best evidence-based practices into their own practice than a BSN is. After all, many ADN programs are just as academically rigorous as BSN programs, without some of the public health and management coursework that the BSN programs do provide. The program that I was in until recently, is actively looking at petitioning to get their program recognized as a BSN program, that is taught at a junior college. They recognize that they will have to incorporate a little bit of new content that is not currently part of their curriculum, and should they be approved for that change in program status, they will simply add the missing content.

Thanks for this and your entire response