80% BSN by 2020: Where Are We Now?

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. Nurses General Nursing Article

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?


References:

Specializes in Retired.
On 12/12/2020 at 10:58 AM, Jedrnurse said:

I'm genuinely confused as to how this relates to the central theme of the post. I thought it was about whether the push for RNs to have a BSN was being achieved.

How are LPNs a part of the solution? Or are you addressing a different problem?

Wouldn't LPN'S be up and running as BSN'S more quickly than high school grad? 

Specializes in school nurse.
3 hours ago, Undercat said:

Wouldn't LPN'S be up and running as BSN'S more quickly than high school grad? 

No doubt. It sounds like you're talking about an LPN to RN bridge program, although most of the ones I've seen over the years are at the ASN level, so it wouldn't immediately address the 80% by 2020 issue brought up by the OP.

Given the long, LONG history of this "goal" I think the only way of forcing it to happen is to streamline the requirement for NCLEX and make it be a BSN. ASN programs could be refocused to prepare candidates to sit for the NCLEX-PN exam.

Specializes in Retired.

Jedmore:  I completely agree with two board exams and elevating LPN to ADN programs.  However, I also think about the ADN program become an RN program for medsurg only so that graduates could work on the floors while getting their courses in the specialties and finishing liberal arts requirements.  This would (IMHO) allow students to graduate with BSN without a lot of debt. At that time, they would also take BSN boards. 

Specializes in Critical Care.
1 hour ago, Jedrnurse said:

No doubt. It sounds like you're talking about an LPN to RN bridge program, although most of the ones I've seen over the years are at the ASN level, so it wouldn't immediately address the 80% by 2020 issue brought up by the OP.

Given the long, LONG history of this "goal" I think the only way of forcing it to happen is to streamline the requirement for NCLEX and make it be a BSN. ASN programs could be refocused to prepare candidates to sit for the NCLEX-PN exam.

I'm not following how that would help move us forward rather than backwards.

This only puts about half of our current RN graduates even farther from a BSN degree.

Also, converting all current ADN programs to LPN programs would cut the output of RNs in about half, while this might create a market favorable to RNs for a short period of time, the lack of RNs would allow hospitals to justify elevating LPNs to the role currently occupied by RNs, and quite possibly some amount of paycut as well.  A relatively small percentage of BSNs could occupy 'specialty' jobs; case management, research, etc. But most would be now stuck taking the jobs they had before (direct patient care) but at reduced pay.  

I'm really not sure how that isn't just a really horrible idea for Nursing.

10 minutes ago, Undercat said:

Jedmore:  I completely agree with two board exams and elevating LPN to ADN programs.  However, I also think about the ADN program become an RN program for medsurg only so that graduates could work on the floors while getting their courses in the specialties and finishing liberal arts requirements.  This would (IMHO) allow students to graduate with BSN without a lot of debt. At that time, they would also take BSN boards. 

What would "their courses in the specialties" be?

On 12/12/2020 at 8:51 AM, Squeamish BBA LPN said:

My LPN program was 18 months et was hospital-based. In 1989 LPNs were still working in ICU in Telemetry. 

In 1989

It is a new decade, century, and millennium

Specializes in Retired.
1 hour ago, MunoRN said:

I'm not following how that would help move us forward rather than backwards.

This only puts about half of our current RN graduates even farther from a BSN degree.

Also, converting all current ADN programs to LPN programs would cut the output of RNs in about half, while this might create a market favorable to RNs for a short period of time, the lack of RNs would allow hospitals to justify elevating LPNs to the role currently occupied by RNs, and quite possibly some amount of paycut as well.  A relatively small percentage of BSNs could occupy 'specialty' jobs; case management, research, etc. But most would be now stuck taking the jobs they had before (direct patient care) but at reduced pay.  

I'm really not sure how that isn't just a really horrible idea for Nursing.

What would "their courses in the specialties" be?

Peds, maternity, public health and what is all not adult med surg.  This may be an awful idea.  Im just trying to think out of the box how to get more nurses out working without big debts.  I guess we can never return to the old Columbia and Cornell models of a much cheaper 5 year program.  A student could get away with 2 years of pre nursing anywhere followed by a 3 year hospital program.  However, when I went for my interview at Cornell, everyone in the room had 4 year degees, but they technically only required 60 undergrad credits.  Minority friendly financial requirements.

But the two year ADN's would be med surg, SNF, LTC qualified.  Call them RN's if you want but the areas where they could work would be limited until they finish BSN.  They would be making nursing wages instead if CNA wages to pay for the extra 60 credits to get BSN.