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 think employers mandating BSN in 5 years upon hire is fair, together with tuition reimbursement it promotes further learning.
I think mandating certification in your chosen specialty rather than writing a million papers will have more impact on patient outcomes. We're missing the mark.
I'm still on the fence about mandating BSN in a specific time frame due to the severe nursing shortage.
I completely agree with you about your certification point. That's a great idea that's affordable and feasible not to mention leading to better patient outcomes according to research
I think mandating certification in your chosen specialty rather than writing a million papers will have more impact on patient outcomes. We're missing the mark.
Mandating certification can be done too. I did not have to write a million papers, not even close, btw.
Specializes in Surgical Specialty Clinic - Ambulatory Care.
This was such a con. Nursing is a trade. It was just wrong and terrible to have this initiative. Basically we are just asking nurses to take on go s of unnecessary debt to accomplish goals that don’t matter. As a BSN prepared RN I have found my credentials to do very little for me. That it would have been way more efficient to get an ASN and work to see if a BSN was something I needed. BSN seems to be only pertinent if one wishes to be in management or higher and has lead to me having a ton of managers that had very little floor experience before ‘moving on’ and managing things they have no clue about. Same can be said for 50% of the NPs I work with. Very little actual experience which leads to me guiding them to appropriate responses. So yay for me, I have to do all the work of taking care of the patient and then also guide the care due to these ill experienced, over educated Yahoo’s. BSN initiative was not a good one for patients, just lead to increased nursing debt, increased useless education as all my schooling prepared me for was a damn test. Working as a nurse has taught me how to be a nurse. Employer provided education has affected my practice far more than my alma matter. Just a darn useless wasteful initiative.
This was such a con. Nursing is a trade. It was just wrong and terrible to have this initiative. Basically we are just asking nurses to take on go s of unnecessary debt to accomplish goals that don’t matter. As a BSN prepared RN I have found my credentials to do very little for me. That it would have been way more efficient to get an ASN and work to see if a BSN was something I needed. BSN seems to be only pertinent if one wishes to be in management or higher and has lead to me having a ton of managers that had very little floor experience before ‘moving on’ and managing things they have no clue about. Same can be said for 50% of the NPs I work with. Very little actual experience which leads to me guiding them to appropriate responses. So yay for me, I have to do all the work of taking care of the patient and then also guide the care due to these ill experienced, over educated Yahoo’s. BSN initiative was not a good one for patients, just lead to increased nursing debt, increased useless education as all my schooling prepared me for was a damn test. Working as a nurse has taught me how to be a nurse. Employer provided education has affected my practice far more than my alma matter. Just a darn useless wasteful initiative.
Perhaps you should question the institution that you attended if you received subpar education. I do agree with you however regarding bedside nursing being a trade/vocation rather than a profession. Are you claiming that you’re helping NPs diagnose and design treatment plans for patients or just helping with interventions? Perhaps it’s the setting/environment that you’re currently functioning at that is attracting mediocre providers. If you’re doing all the work, either these providers are inept or you have an inflated imagination of your capacity. Hard to tell. A wise man once said that if you’re the smartest person in the room then you’re in the wrong room.
Specializes in Surgical Specialty Clinic - Ambulatory Care.
3 hours ago, cynical-RN said:
Perhaps you should question the institution that you attended if you received subpar education. I do agree with you however regarding bedside nursing being a trade/vocation rather than a profession. Are you claiming that you’re helping NPs diagnose and design treatment plans for patients or just helping with interventions? Perhaps it’s the setting/environment that you’re currently functioning at that is attracting mediocre providers. If you’re doing all the work, either these providers are inept or you have an inflated imagination of your capacity. Hard to tell. A wise man once said that if you’re the smartest person in the room then you’re in the wrong room.
Ha! So short answer is yes. I have done travel nursing and have been a BSN prepared RN since I graduated in 2008. I have worked at MANY institutions and find that in teaching facilities the whole “me running the show” thing not to occur as often. But you have to admit that there is something wrong with a system when the MD is asking the NP for treatment options for inflammation pain when the patient is on thinners and the NP response with Ibuprofen first and Toradol second. Or when you are working in the ER and the patient is complaining about having a bug in her ear, the MD won’t look in the patient’s ear, I do and find that she has perforated her ear drum and he tells the patient that he is setting her to follow up with an ENT because “he isn’t an ENT so he wouldn’t be able to tell if she perforated her ear drum or not.” (Like I’m not a dentist, but I can tell when you are missing a tooth.....unless I don’t look in your mouth?!). My point being that the push for BSN preparation didn’t teach me those assessment skills, working in a level 1 trauma environment did. My BSN was wasted money for me because I have no desire to be in management or “go up the chain”. The $0.50 is not enough incentive for a $47k program. Especially when my friend who is an ASN prepared RN spent $12K for hers. I think we should focus on the vocation and encourage BSN bridge programs for advancement to those who want it. Not push for everyone to get a BSN. Your employer should provide any additional education for care until you decide you have a reason to go back to school.
Ha! So short answer is yes. I have done travel nursing and have been a BSN prepared RN since I graduated in 2008. I have worked at MANY institutions and find that in teaching facilities the whole “me running the show” thing not to occur as often. But you have to admit that there is something wrong with a system when the MD is asking the NP for treatment options for inflammation pain when the patient is on thinners and the NP response with Ibuprofen first and Toradol second. Or when you are working in the ER and the patient is complaining about having a bug in her ear, the MD won’t look in the patient’s ear, I do and find that she has perforated her ear drum and he tells the patient that he is setting her to follow up with an ENT because “he isn’t an ENT so he wouldn’t be able to tell if she perforated her ear drum or not.” (Like I’m not a dentist, but I can tell when you are missing a tooth.....unless I don’t look in your mouth?!). My point being that the push for BSN preparation didn’t teach me those assessment skills, working in a level 1 trauma environment did. My BSN was wasted money for me because I have no desire to be in management or “go up the chain”. The $0.50 is not enough incentive for a $47k program. Especially when my friend who is an ASN prepared RN spent $12K for hers. I think we should focus on the vocation and encourage BSN bridge programs for advancement to those who want it. Not push for everyone to get a BSN. Your employer should provide any additional education for care until you decide you have a reason to go back to school.
Those are some valid examples you provided. Much is left to be desired from such providers. NP education and licensure is quite fragmented and without reasonable standardized consistency. I think that’s problematic. In fact, nearly, all of nursing lacks standard cohesion with the exception of CRNAs and midwives. Look at how many ways someone can become an RN or NP. Nonetheless, 47K for a BSN in 08 after ASN? That’s outrageous, if not midday robbery. My ASN costed 3K and BSN 12K. Interestingly, LPN diploma was slightly under 20K (now I know that for one to be old and wise, you first must be young and dumb LOL). Most private institutions (higher learning cartels) are running amok.
Specializes in Surgical Specialty Clinic - Ambulatory Care.
to.
1 hour ago, cynical-RN said:
Those are some valid examples you provided. Much is left to be desired from such providers. NP education and licensure is quite fragmented and without reasonable standardized consistency. I think that’s problematic. In fact, nearly, all of nursing lacks standard cohesion with the exception of CRNAs and midwives. Look at how many ways someone can become an RN or NP. Nonetheless, 47K for a BSN in 08 after ASN? That’s outrageous, if not midday robbery. My ASN costed 3K and BSN 12K. Interestingly, LPN diploma was slightly under 20K (now I know that for one to be old and wise, you first must be young and dumb LOL). Most private institutions (higher learning cartels) are running amok.
Thanks for your responses. I got my BSN for 47K. I did not get an ASN...my friend who has been working with me off and on since 2008 got her ASN for 12K. Which is a big reason I feel it is such a sham. We grew up in nursing together, starting with our first job. We have done ICU and ER together. She has out paced me in hourly wage due to deciding to be a director at a nursing home. (Admittedly not a job I would want.) But she never furthered her education and has been able to do everything I have. So I really don’t feel there should be such a push for it.
Thanks for your responses. I got my BSN for 47K. I did not get an ASN...my friend who has been working with me off and on since 2008 got her ASN for 12K. Which is a big reason I feel it is such a sham. We grew up in nursing together, starting with our first job. We have done ICU and ER together. She has out paced me in hourly wage due to deciding to be a director at a nursing home. (Admittedly not a job I would want.) But she never furthered her education and has been able to do everything I have. So I really don’t feel there should be such a push for it.
Very interesting that your friend makes more than you with “less education”. Nursing education is too gray currently. That’s is partly why I think having the minimum entry be a BSN. That way, wages will go up across the board for everyone and perhaps tuition will be more reasonable because of competition and standardization. Furthermore, education will be more cohesive if all institutions are required to meet similar criteria. One can then tell that a person received quality education and clinical experience irrespective of geography. I know things shouldn’t stay the way they are for a variety of the reasons we’ve discussed and more.
Very interesting that your friend makes more than you with “less education”. Nursing education is too gray currently. That’s is partly why I think having the minimum entry be a BSN. That way, wages will go up across the board for everyone and perhaps tuition will be more reasonable because of competition and standardization. Furthermore, education will be more cohesive if all institutions are required to meet similar criteria. One can then tell that a person received quality education and clinical experience irrespective of geography. I know things shouldn’t stay the way they are for a variety of the reasons we’ve discussed and more.
I think the only way that BSN standardization will make wages go up is if fewer people go to nursing school resulting in an actual nursing shortage.
Wuzzie
5,238 Posts
I think mandating certification in your chosen specialty rather than writing a million papers will have more impact on patient outcomes. We're missing the mark.