BSN vs ADN

Susie2310 · Dec 8, 2012

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Grizabelle · Dec 8, 2012

Jean Marie, I think part of the kicker to the idea of a 2 year degree is to remember that most of the time, there is at least a year's worth of prerecs for the 2 year program that includes things like A&P, pharmacology, microbiology, etc.

FWIW I had to have 60 hours of prerecs before admittance to my BSN program but the program itself is 4 semesters.

darmor11 · Dec 11, 2012

Jean Marie, I think part of the kicker to the idea of a 2 year degree is to remember that most of the time, there is at least a year's worth of prerecs for the 2 year program that includes things like A&P, pharmacology, microbiology, etc.
FWIW I had to have 60 hours of prerecs before admittance to my BSN program but the program itself is 4 semesters.

You hit the nail on the head. The so called "2 year degree" really isn't two years because of the prereqs you have to complete prior to applying for the nursing program. Once accepted into the nursing program, then it takes 2 more years to complete the program and get your ADN. So basically, it can take someone 3 to 5 years to get their ADN, which makes no sense to go that route because you can spend that same amount of time and get your BSN.

PinkNBlue, BSN, RN · Dec 12, 2012

You hit the nail on the head. The so called "2 year degree" really isn't two years because of the prereqs you have to complete prior to applying for the nursing program. Once accepted into the nursing program, then it takes 2 more years to complete the program and get your ADN. So basically, it can take someone 3 to 5 years to get their ADN, which makes no sense to go that route because you can spend that same amount of time and get your BSN.

Exactly, regarding it not actually being "only two years". It may make sense to some though, mostly for financial reasons as well as location. Had the community college that I attended and obtained my ADN at offered a BSN program, then I may have considered it instead of ADN but the financial aspect among other things worked better for me. So it depends on the person, IMO.

Orca, ADN, ASN, RN · Dec 12, 2012

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.

llg, PhD, RN · Dec 12, 2012

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.

classicdame, MSN, EdD · Dec 12, 2012

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"

Susie2310 · Dec 13, 2012

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.

UVA Grad Nursing · Dec 13, 2012

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 · Dec 15, 2012

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.

DoGoodThenGo · Dec 17, 2012

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.

RNpearls1908 · Dec 17, 2012

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