CNA>LPN>RN or straight to ADN?

pixiestudent2 · Jan 22, 2012

I say go staight to RN. If you get waitlisted take the cna class while you wait for your RN program to start.

nurseprnRN, BSN, RN · Jan 22, 2012

none of the above:d. you should also look into identifying a bachelor's-in-anything-to-bsn accelerated degree program that will give you a leg up and give you some credits for your previous degree. why limit yourself to an adn when you can have a bsn in approximately the same time?

one of the most contentious issues in nursing is the level of education needed for a profession. as many of the an'rs know, i come down squarely on the side of a bs in nursing or bsn as entry-level educational preparation. when i had smaller kids and they asked me a question, i always asked them, "do you want the short answer or the long one?" since i can count on the fingers of one hand the number of times they ever said, "short" and still have enough left over for the boy scout salute, here it is again.

(disclaimer: have worked as a staff nurse, inservice/staff development, instructor, nclex prep course instructor, case manager in multiple settings, and other stuff too numerous to mention. in short, been around, seen that, done that.)

what's a profession? is nursing a profession? what's the basic educational prep for people you think of as professionals? would you want your chemistry research done by someone with an associate degree? your child taught high school math or english? your income tax advising? sure, there are good people with lower level education who succeed in life, but don't let that "we all have the same license and sit for the same exam" fool you. better education makes you better at what you do. there are any number of people who can give you examples of bsns or mns who don't know how to take a rectal temp (why does everyone focus on that and bedpans when they think of nursing, anyway?) and marvelous old lpns who saved the resident's butt one dark and stormy night, but for every single one of those i will see your anecdote and raise you half a dozen godawful errors made by nurses who didn't take the coursework and didn't get exposed to the idea of autonomy in school.

time: the bachelor's degree takes four years (accelerated, less). the associate's degree (as or asn) takes ... three and a half, once you count all the prerequisites you're going to have to take before they admit you into the nursing program. and those who say you can work on your bsn while you are working as an rn with an as don't tell you (and maybe don't know, to be charitable) that many of your course hours from the as program are not transferable, so it won't just be a matter of a semester or two or three. and working as a nurse is hard, almost as hard as nursing school ... think you'll have the mental, physical, social, and financial energy for more education at the same time? oh, and in most jurisdictions you can't sit for the lpn exam and work as one while partway thru a as or bsn program anymore, either.

job opportunities: although the old a-nurse-is-a-nurse-is-a-nurse attitude is fortunately fading away, at entry level for new grads, about the same, and i realize that people who are just starting out have a very incomplete idea of what it means to be a nurse. however, look around the place and see who's working. are you planning to be older some day? do you see older nurses working in those entry-level staff or charge positions? if not, where did they all go? why do you care? well, suppose you work on a general medical floor and get entranced by cardiac rehabilitation after following a patient who did it. a job comes up in the department, hooray! oops, bsn only. or you find your heart drawn to helping underserved women in a public health clinic for high-risk pregnancy. sorry, bsn only in public health. after five or six years as a staff nurse you have become a resource to new hires and your peers and you realize you have a gift for teaching. you see that a position in staff development has come open, and you are first in line at hr to apply. you got it.... bsn is the minimum. school nursing? bsn. hurt your back and want to go for a job in case management? bsn. you discover you have a gift for asking, "why do we do it this way?" and are amazed to find you want to look into jobs in management or nursing research.....bsn minimum. you are starting to get the picture now. also, many, many practice settings give you a differential for bsn. no, i know, not all, but hey. one more factor.

growth: the questions in the licensure exams (nclex) are developed from errors made in the first year of practice by new grads, and regardless of pass rates from different level programs, anyone in practice can confirm the research: in the first year of work all new grads perform at about the same level as they get their feet under them and get used to the idea of working as an rn. but after that year, the bsns pull ahead in ways that are related to their higher level of education. why? because what we call in the ed biz "psychomotor skills," the things you do with your hands, can be done by anyone with enough practice. hell, we teach lay people how to do peritoneal dialysis at home or suction tracheostomies. but the understanding of why some things are as they are is something you get in better education: more science, more sociology, more psychology, more history, a basic statistics class, exposure to more clinical settings (i doubt if you'll get a full semester in peds, psych, ob, or any public health at all in any as program) give you the insight to ask better questions and make better decisions.

if you really want to be a nurse, don't you want to find yourself in the camp of folks who are grateful they learned more, rather than the ones who find they had to for advancement or competence and wish they'd done it in the first place? my answer is clear.

Iâ™¥Scrubs, LPN · Jan 22, 2012

I understand what you mean. But you want me to go for my BSN which I can't afford, and actually if I get accepted to this ADN program, I will have all the pre-reqs except one from my previous college, so it will only take me two years, and if I climb the ladder, it will take a year since I would have advanced placement. And I have to take a lot of psych and sociology currently because I am a human services major. I also realllllly do not want to be at school for another four years. If I have to then sure, but I know of plenty of jobs where I live that I found where you can have your ADN.

escapebigd · Jan 22, 2012

I was a CNA and now I'm doing the ADN program. I'm noticing a lot of the first semester skills I learned from being a CNA. I think my time as a CNA was valuable and is helping me now in the ADN program. I can't speak for the extra step of being an LPN though. I think if you did the CNA to ADN that would be a good choice (but that is just speaking from my own experience).

anjoba · Jan 23, 2012

Personally, as a former CNA (1 yr) and now LPN, I am glad I did it step by step. While I have aspirations for a higher degree (BSN or NP), I feel like learning "the steps" of healthcare was easier for me. I'm also a former social worker of six years so that helps in communicating with pts, but for not having much exp. with healthcare otherwise, I'm good w/my choice! No matter what route you take, I truly believe one doesn't know really what nursing is, until one practices it whether it be RN, LPN, or CNA. I'm a charge nurse where I work so the RNs and LPNs all have the same job description and duties....

noahsmama · Jan 23, 2012

I understand what you mean. But you want me to go for my BSN which I can't afford and actually if I get accepted to this ADN program, I will have all the pre-reqs except one from my previous college, so it will only take me two years, and if I climb the ladder, it will take a year since I would have advanced placement. And I have to take a lot of psych and sociology currently because I am a human services major. I also realllllly do not want to be at school for another four years. If I have to then sure, but I know of plenty of jobs where I live that I found where you can have your ADN.[/quote']
If you already have a bachelor's degree in another field, you don't need to go to school for another 4 years to get a BSN. You are eligible to enter an accelerated BSN program, which depending on the program, will take you 12 to 18 months (vs. 24 months or more for an ADN program). The prerequisites for accelerated BSNs are similar to ADN programs, so you may already have the prerequisites too. You're right though that the accelerated BSN programs tend to be much more expensive than ADN programs. Before you write them off though, I think it makes sense to get more information about accelerated BSN programs in your area. If you get an ADN, you could eventually do an RN to BSN bridge program, but of course that will take additional time and money.
There's no one right answer here -- I think it makes sense to research all your options before making a decision. Another thing to look into is how the job market is for ADN-RNs in your area. In some areas ADN-RNs have no more trouble finding a job than BSN-RNs -- in other areas, most major hospitals are requiring or "preferring" BSNs, so find out what the deal is in your area.
Good luck!

dee78 · Jan 24, 2012

I have chosen the CNA>LPN>ADN, and eventually BSN>MSN route. I originally planned on just ADN, but when plan A fell through I went with plan B. I earned my LPN and 6 months later entered a bridge to RN program. I will graduate in May!!

We all make decisions based on our current needs. I would look into the Accel BSN program, see what options you have for loans and scholarships. But I understand the $$$ issue, that is why I have chosen the route that I have taken. I needed to be able to support myself and my kids at any point along the way.

Good luck with your decision.

JulieL · Jan 24, 2012

Hi Sali22,

Alot of what GrnTea says makes sense, and I think an accelerated BSN might be what I would choose for myself if I had that opportunity.... but I had the opportunity to attend an ADN program and I am very grateful to be here! (Almost done!)

I have noticed that my classmates who have worked as CNAs (or even unit secretaries for that matter), and now in the second year of my program a few LPNs have joined us, ...... they seem to be doing really well, as in "struggling less."

They have experience in dealing with patients and with time management. The LPNs have a thorough understanding of the medications. They are calm in the clinical setting. They can multi-task. I wish I would have been braver and gotten an CNA job before getting into nursing school, rather than sticking with waitressing which was more comfortable for me. I would have a broader view on the field of nursing than I do as a 2nd year ADN student with no medical experience. And also by working your way up through the ranks, you will understand about delegating tasks, something an RN needs to be able to do, and you will have the attitude of "I know how it is, I have done it myself." And that should gain you alot of respect from your peers. Explore the options and keep an open mind.

Good luck,

JulieL

Living4Peace · Jan 24, 2012

As others have stated I would suggest trying to get into an accelerated nursing program. It usually is about a year to complete, and it seems like you have most of the prereqs, and if you don't but have them all completed you still can be accepted as long as you have them completed by the time of entry into the program.

On another note, if you don't have the time to devote to full-time study that an accelerated program would accompany I suggest getting an Associate's degree. Your options may be limited, but you will have options. Do what you can afford, not only financially but circumstantially. Being a nurse with an ADN is ok, you can still get hired. As for becoming an LPN>RN, don't waste your time. The time put into that could be used towards becoming an RN and getting to your end goal faster. Being a CNA as you work towards your goal of becoming a nurse while in school might be a good idea.

Moreover, don't allow people to get into your head and think of ADN nurses are inferior. The test of time has shown that they are as competent as their BSN counterparts or else the option of getting a degree as a RN from a community college would have long been done away with. The debate is solely political.

Nursing is about supplying your patients with care. As a profession their are intricacies, but a lot of it is basic care and critical thinking. ADN offering schools can equip a student with these skills just as well as any other.

rosemadder · Jan 30, 2012

I didn't get my CNA before RN school...In my area it is now required. I had no problems with my program without having my CNA though I was a little slow on patient care in the beginning. If it's not required to be a CNA for school and you don't plan on working part-time as one I would skip it.

pixiestudent2 · Jan 30, 2012

At my school after the first semester you are allowed to work as a nurse tech/ NA. so i feel that your just putting your goal off by becoming a CNA. They will teach you everything you need to know in nursing school.