In 2010, the 80% BSN by 2020 initiative rolled out in an effort to boost nursing’s competency level. Have we reach the 80% goal? Read on to find out if we’ve made progress over the past 10 years.
A decade ago, our healthcare system was growing more complex and patients were sicker than ever. In response, The Robert Wood Johnson Foundation and the Institute of Medicine (IOM) rolled out a 2-year initiative to determine if the nursing workforce was prepared to face these challenges. Data was gathered, analyzed and in 2010, the IOM released a report of evidence based recommendations to improve the skill and competency of working nurses.
80% BSN by 2020
The report was clear… nurses needed a higher level of education. Therefore, the IOM pushed for more BSN nurses by setting the goal of 80% of RNs earning a BSN by 2020. When the report was released in 2010, only 49% of nurses were educated on a baccalaureate level.
Distinct Differences
BSN and ADN nurses fill many of the same positions, with both performing similar tasks. But, there is a growing number of research studies that show BSN graduates bring greater skill to their work than ADN or diploma graduates. The American Association of Colleges of Nursing (AACN) provides an overview of numerous studies in the fact sheet, The Impact of Education on Nursing Practice.
According to research, BSN graduates are better prepared to:
Use evidence-based practice
Analyze data
Implement and manage projects
Communicate with other disciplines
Promote patient safety
Work in leadership positions
Nurses with a bachelor degree have also been linked to:
Lower odds of patient deaths
Better patient outcomes
Leading to lower costs
Fewer adverse events
Fewer medication errors
Stronger use of research
Stronger leadership skills
Progress Towards Goal
The nursing profession won’t meet the goal of an 80% BSN workforce by 2020, but progress is being made. The Future of Nursing’s Campaign for Action works to implement the IOM’s 2010 recommendations. Here is a quick look at their progress:
Starting in 2012, the number of nurses graduating with a BSN, including RN-to-BSN, is higher than those graduating with an associate degree.
From 2010 to 2012, the number of RN-to-BSN graduates increased by 180%.
In 2018, the percentage of working nurses with a bachelor's degree (or higher) was up from 49% in 2010 to 57% in 2018.
Since 2010, the number of nurses with a doctorate degree has doubled.
To reduce the hurdles faced by nurses in obtaining advanced degrees, 30 states are now enrolling nursing students into 1 of 5 promising program models:
RN-to-BSN degree from a community college to allow RNs to complete bachelor education at a community college
State or regionally shared outcomes-based curriculum
Accelerated RN-to-MSN programs
Shared statewide or regional curriculum between universities and community colleges.
Shared baccalaureate curriculum to shorten the time between obtaining an associate and a bachelor's degree.
Making it Easier to Return to School
ADN graduates share common concerns about returning to school. Online RN-to-BSN programs are designed to address these concerns by:
Building on previous education to shorten the time it takes to earn a BSN
Providing multiple start dates for RNs to enroll at a time convenient for them
Formatting coursework to be completed at a time and place that works best for the student
Making online programs more affordable than traditional campus-based programs
Nurses may also qualify for loan forgiveness and loan-for-service programs
BSN Minimal Degree for Entry Level Nurse
The American Association of Colleges of Nursing (AACN) stated in a draft position paper the organization “strongly believes that registered nurses should be minimally prepared with the bachelor of science in nursing or equivalent nursing degree”.
So where does this leave the associate level nurse? The National League for Nursing (NLN) argues entry points into the nursing profession shouldn’t be limited, as more nurses are needed to ease the nursing shortage. In addition, the NLN argues 2-year community college programs are “front and center in attracting students of color and those who may be marginalized by economic disadvantage”.
Does The ADN Still Matter?
We are all feeling the strain of the nursing shortage, especially as the pandemic marches on. What does this mean for ADN graduates? It’s impossible for baccalaureate programs to graduate enough nurses in a time-frame needed to fill the current (and future) shortage gap. Both inpatient and outpatient settings need all the nursing “hands on deck” they can get. So, the answer is a loud “YES”, associate trained nurses are still needed and new grads will have no problem finding a job.
What Do You Think?
Do you agree with requiring a percentage of working nurses to hold BSNs? Also, is it fair for employers to mandate the nurses they hire to obtain a bachelor degree within a specific time-frame?
I see nothing has changed much in this discussion of ADN vs. BSN
I'm now at the point I was an ADN for half of my nursing career and I got my BSN in 2007 and have been a BSN for the last half. For me it has been time and experience that have made me a better clinician and critical thinking, not my degree.
However, at the end of the day I do support the idea of BSN being the degree for nurses.
However, telling an ADN that's worked for you 25 years that they must get a BSN will not make that nurse a better nurse and perhaps shouldn't be forced.
I agree 1000%! My BSN completion program did nothing for practice. Targeted professional development and supportive work environments with learning opportunities were much more important.
I also think that the profession should just stop with the delay and make the BSN the entry requirement to take the boards. Grandfather current experienced nurses (but none of that "you have to get your BSN nonsense").
Change the community college ADN programs to nursing prep (coordinated with four year schools) transfer programs. Make CNA certification part of the preparation. This pathway makes it less expensive and gives people the time to focus on the science, math and psych. (Heck, why not require a foreign language component of the prep degree...)
On a different educational matter: Require significant clinical experience for advanced practice roles and get rid of those non-nurse direct entry graduate programs!
In my experience, entry level BSN nurses just think they are smarter, but their practice shows the truth.
It totally depends on the school and instructors. I've met newer nurses at every level (LPN, ADN, BSN, MSN) that I would beg to take care of me and mine, and others that I would rather die first than receive care from. The alphabet soup behind the name means so little
The hospital I work for was recently bought out again and they are encouraging RNs to get the BSN with pay increases and tuition reimbursement at 100%.
And then many of them have such a miserable work environment and impossible demands that the first thing people (now) seem to want to do is get the H out of there if they went to the trouble to get the degree.
That's the part where things start to get illogical unless you consider that maybe the whole thing doesn't mean to hospital corporations what nurses want to think it means about themselves, their professional regard and their better degrees and their supposedly better patient care. The corporations don't seem to care if these BSNs don't stay at the bedside very long, and that very attitude of theirs is completely suspect. They want BSNs but are fine with completely perpetual non-expertise at the bedside? Something rotten there.
I strongly suspect that for huge hospital corporations the BSN thing is tied into their motivation to get nurses into the provider pipeline. Because if they can do that, now you're talking about some significant advantage to them.
I got my BSN for one reason. To give me a little more flexibility job wise when I get to the point that I can’t do bedside anymore. Which is probably coming in the next 5 years or so.
That's why I got my BSN as well. At age 50 I was a little burned out and used my BSN to get a desk job as the Admit-Transfer Manager. Hated it and went back to the bedside after six months.
Now I'm 61 with nine more years to work and wonder what BSN required non-bedside nursing position I could do should I physically or mentally not being able to handle the bedside. But that's just hypothetical thinking.
And then many of them have such a miserable work environment and impossible demands that the first thing people (now) seem to want to do is get the H out of there if they went to the trouble to get the degree.
That's the part where things start to get illogical unless you consider that maybe the whole thing doesn't mean to hospital corporations what nurses want to think it means about themselves, their professional regard and their better degrees and their supposedly better patient care. The corporations don't seem to care if these BSNs don't stay at the bedside very long, and that very attitude of theirs is completely suspect. They want BSNs but are fine with completely perpetual non-expertise at the bedside? Something rotten there.
I strongly suspect that for huge hospital corporations the BSN thing is tied into their motivation to get nurses into the provider pipeline. Because if they can do that, now you're talking about some significant advantage to them.
Yep. A good deal of people I've seen go ADN to BSN did so to either get an ARNP or to leave the bedside because the BSN gives them a bit more mobility and marketability for better or worse. I would think the hospital is aware of this and yes I do think it's partly a marketing strategy.
I also went back for a useless BSN. “We will take your work history into account and give you credit,” the university said. Not so. I went through the same classes as everyone else in my cohort, wrote the same endless papers and did the same time consuming interviews that did nothing to improve my bedside care. AACN was big into promoting the 80% BSN by 2020 in order to maintain Magnet status. My hospital was so far behind in achieving that goal, besides the hostile work environment that we would never have been able to achieve our 4th magnet designation. Really I think attending relevant conferences and studying related topics to your position (from home) are more beneficial than an advanced degree. It seems that people who go on for BSN and more are looking to get away from the bedside. We need those with RN behind their names at the bedside not behind desks pushing papers around. I work dual roles, and really think that most of my time should be patient care at this point in the “pandemic” not planning education for people who are so busy at the bedside that they can’t absorb much less attend educational events. I pick up 2-4 extra 12 hour shifts a pay period to help out. But really I think that all RNs should be helping at the bedside at least some hours! Whatever happened to patient care? Isn’t that what this business is all about?
Having been an ICU nurse for my entire nursing career spending a little more than half as an ADN, which I truly think should be referred to as an ASN on here as that is what the degree is, just like we call it a BSN, I can provide a little insight.
There are different associate degrees though, Associate Degree in Nursing (ADN), Associate of Science in Nursing (ASN), and Associate of Applied Science in Nursing. Iirc the ADN is more common so that’s what we default to.
I overheard my husband on the phone to a colleague. "She is going for a BSN...No she will not work a different job... no there is no raise to go with it..yes, but 22 years experience won't open certain doors without that degree...no she isn't really excited about it..".
Sums it up. The rules changed midstream. When I started, degrees were downplayed, and having relevant experience is what got you better jobs.
Now I am facing getting older. Most of the better jobs and almost all of the non-bedside jobs are all locked up behind glass, and you need a BSN to land one of those jobs around here.
So now I am paying multiple college tuitions for myself and my children.
I started my BS classes right before covid hit instead of going to work. It seemed at the time they would end up offering some help in better patient care. What happened instead because of covid is every clinical class was transitioned to online because of covid and in the past year we have learned almost nothing related to patient care. Instead we learned topics like how to critique research, managing staff nurses, scheduling, hospital finances, etc. It's been challenging to even get a grasp on topics because for myself and many of my peers our last patient interactions were in late 2019. I have less than a month left until I complete my BS degree and I feel no more prepared to care for patients than I did when I completed my AAS degree.
I started my BS classes right before covid hit instead of going to work. It seemed at the time they would end up offering some help in better patient care. What happened instead because of covid is every clinical class was transitioned to online because of covid and in the past year we have learned almost nothing related to patient care. Instead we learned topics like how to critique research, managing staff nurses, scheduling, hospital finances, etc. It's been challenging to even get a grasp on topics because for myself and many of my peers our last patient interactions were in late 2019. I have less than a month left until I complete my BS degree and I feel no more prepared to care for patients than I did when I completed my AAS degree.
At least it sounds like some of these skills could prove useful down the line...
Specializes in ICU/community health/school nursing.
Mr. Ruby Jane is an ADN-prepared nurse who got his BSN a couple years ago to work his way into management. I am a second-career nurse who envies Mr. Ruby Jane's technical skills BUT - there was an actual nursing shortage when he became a nurse, and he had some amazing preceptors. When I became a nurse we had just started talking about the BSN requirements and my preceptor, among others, was sort of dead set to prove that my BSN really didn't matter.
I am weary that we continue to talk about this. Someone mentioned that the requirement may be a deal-killer for second career nurses who come from diverse backgrounds, which is what we desperately need right now. The whole recommendation is based on a miniscule data set anyway. What is more important is how the institution trains up the nurse.
And right now, do we really have time to argue about this? The BSN will get you into management and into grad school. Use it for what it is.
I overheard my husband on the phone to a colleague. "She is going for a BSN...No she will not work a different job... no there is no raise to go with it..yes, but 22 years experience won't open certain doors without that degree...no she isn't really excited about it..".
Sums it up. The rules changed midstream. When I started, degrees were downplayed, and having relevant experience is what got you better jobs.
Now I am facing getting older. Most of the better jobs and almost all of the non-bedside jobs are all locked up behind glass, and you need a BSN to land one of those jobs around here.
So now I am paying multiple college tuitions for myself and my children.
The writing was on the wall in 1972 when I started BSN program so it's not like you didn't have enough notice to pick your degree up until now. IF a mandatory BSN would limit our numbers making us more valuable employees, we would all be better off. ADN for LPN's might not be a bad idea either if it gave them more access to some of acute care jobs in less intensive settings.
Jedrnurse, BSN, RN
2,776 Posts
I agree 1000%! My BSN completion program did nothing for practice. Targeted professional development and supportive work environments with learning opportunities were much more important.
I also think that the profession should just stop with the delay and make the BSN the entry requirement to take the boards. Grandfather current experienced nurses (but none of that "you have to get your BSN nonsense").
Change the community college ADN programs to nursing prep (coordinated with four year schools) transfer programs. Make CNA certification part of the preparation. This pathway makes it less expensive and gives people the time to focus on the science, math and psych. (Heck, why not require a foreign language component of the prep degree...)
On a different educational matter: Require significant clinical experience for advanced practice roles and get rid of those non-nurse direct entry graduate programs!