BSN vs ADN

[Grizabelle]

No... I do not want to get into which one is better.

I am in a BSN program, it was the best choice for me for a number of reasons and I am happy with that choice.

I am simply curious why some people say BSN nurses are "lost" on the floor when they get hired so they would rather have ADNs. I have a friend that is in an ADN program and we appear to have the same quantity of hours in clinicals, we do clinicals at mostly the same hospitals, the care plans we do sound pretty similar other than I have to do some additional work for mine. She does her classes in a compact format so instead of taking Psych and Care II each for a whole semester her program split the semester up and she did Psych half time and Care II half the time.... so in the fall semester we did the same classes except that I also had research and Gero. We have both been busy with school so havent had time to compare anything else other than I have the few random classes like Path, Research and leadership that she doesnt get... but taking those shouldn't make me less effective on the floor.

It sounds like its a reference to clinical experience but if the amount of clinical time is the same with the same random luck opportunity to actually do things like trach, ostomy or wound care. Random odds of starting IVs that either one of us may or may not get...

What is the difference and why is the assumption an ADN will have more practical experience?

Is this just an assumption that BSN nurses will be less task oriented?

[PatMac10,RN, RN]

That is generally true for all of nursing, regardless of baseline degree.

Well, there is Linda Aiken's study from U of Pennsylvania.

I already stated in another thread that two year schools should just focus on preparing nursing students for four year programs, helping them with transferrable GE courses, and giving them mentoring programs, for which they would obtain transferrable credit. This would save on the cost of obtaining the four-year degree, and it would help students get insight into whether or not this is the right field for them--and if it is what they think it is. If they find out it's not, they won't lose the GE credits and may transfer them to another area of study.

But the two year programs just need to stop with the whole ADN deal. It's pretty much a dead that anything other than a basic four-year program of study in nursing is the educational standard for entering practice. It's enough already. Make it such that unless you have that four-year degree in nursing, you can't sit for the NCLEX.

Honestly, I don't see what the big deal is. If nursing is ever going to raise up to a professional standard, it's the only way to go. But I would make the clinical requirements and experiences for those in four-year programs tougher, so to help prepare them better for clinical functioning after graduation.

Overall, however, the 4 yr degree isn't as much about individual practice per se. You develop that after you graduate and practice for a while. You decide what kind of practitioner you will be. It may, however, set the tone for the how you will practice.

It's about moving the profession forward--and in this it has been kicking and dragging its feet for more than 3 or so decades. It's totally lame.

It's ridiculous to me that people can become RNs in two years. Physicians and student physicians frequently jest about this.

Do you know what you are if you have a two-year degree in teaching? A teacher's aide. I'm just saying. . . it's time to get real about the whole thing.

Your suggestions are unrealistic at this time however. The number of BSN prepared nurses is on the rise, but the majority of nurses are still educated and prepared at associate degree level.

If one were to do some simple research, one would find that ADN programs are preparing people to go and get there BSN. Think of all the RIBN and bridge programs being created. People are realizing that it is more cost effective in this difficult economy for individuals to receive part of their education at a community college. This way people can get into work faster and finish the remainder of their education with a seamless transition.

I go to an ADN program and 90% of our class plans to enroll in the university bridge program associated with our school. We have a whole nursing leadership and management course, have community health rotations at the health department, write multiple 15+ Page papers in APA a semester, and we due care management rotations. We are what my program director calls and "evolved" ADN program. She says she doesn't want us to enter our degree completion program not being exposed to most of the information that we will learn, at least once in our initial education.

Since first semester, Our care plans are graded every week and we must include and EBP or research article r/t our patients reason for hospitalization or dx, complete a pathophysiology informational sheet about our pt. dx, and give a smart of however will implement EBP in our clinical practice as a student. At the end of our semester we had to include how we implemented EBP throughout or while semester. So if anyone from my ADN program doesn't know how to implement EBP by now, it's not bc they didn't learn how to.

Oh, and I didn't get a summer break, I was in school also summer.

[PMFB-RN, RN]

I'm always surprised, when i hear people refer to a "2 year" ADN, and wonder, have things changed nowadays? Are there really 24 month ADN degrees now? WOW!

EMBARRASSINGLY, i am not entirely certain of the difference, if any, between an ASN and an ADN, i always think it is just symantics.

*** Yes absolutly there are two year associates degree RN programs. There isn't a real degree called an "ADN". ADN is a catch all to describe associates degree programs. There are differences among associates degree programs. Some schools (like mine) grant an Associates of Applied Science in Nursing (AASN). Other colleges grant an Associates of Science in Nursing (ASN). The main difference is in general education. Typicaly an AASN will have 1/3 of the credits in general educations vs 1/2 the credits in education for the ASN.

My program did not have any college class pre-reqs except a 2 credit online chemistry for those who did not take chem in high school and could be (and was/is by many people) completed in 4 semesters. Thats how we end up with a few 19 year old RNs in my hospital each year.

[PMFB-RN, RN]

I serve as a preceptor and instructor in a large hospital's Critical Care Nurse Residency Program. We hire both BSN and ADN grads. We find the BSN grads to be a little more expensive to train since the local BSN programs simply don't teach the skills the ADN programs do. For example our ADN grads come to us competent in blood draws and IVs. While they may not be skilled at getting the hard sticks they understand the process and can do IVs on their own on patients with good vessels. In addition they understand why we have different IV sizes and when to choose a 22 ga vs an 18 ga. The BSN grads simply don't know this and we must train them at additional expence for the hospital. Not just IVs but other skills as well. While the BSNs are learning basic skills the ADNs are sitting in hemodynamic monitoring or pharm classes. My observation is that this gives the ADN grads a slight edge since they get to move on to advanced subjects sooner.

That said by the end of the 9 month residency there are no differences between them, at least among those that make it to graduation. The washout rate is also slightly higher for the BSN grads. My observation is that the BSN grads tend to be much younger and come to us with less life experience and fewer coping skills to get them through the demanding and high stress residency program vs the ADN grads who are often in their late 20's to late 40's and come to use with considerable life & work experience. Obviously there are older BSN grads and younger ADN grads who are exceptions.

Another thing we have found is that the BSN grads have a much lower contract completion rate. The contract completion rate was so low among the BSN grads hired for the SICU that they are simply not hired for that unit anymore. The ADN contract completion rate is (so far) 100%.