Do Bachelor's Degrees Save Lives? - The Facts about Earning a BSN

In most lines of work, there’s one clear path to getting your foot in the door. But nursing is unique in that it offers multiple paths to entry-level positions. Whether you’ve earned a diploma, an associate degree or a bachelor’s degree, you know there is more than one way to become an RN. Nurses General Nursing Article

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Some assert that there are some pretty distinct differences in the capabilities, responsibilities and patient outcomes that come with each educational milestone. It's no secret that more voices in the field are citing those differences as a driving force behind the push to convince more RNs to pursue BSN degrees. But are the benefits as clear-cut as they've been made out to be?

Here's what we found from doing some research on what has been written.

The push for more BSNs

Initiatives like "80 by '20" and "BSN in 10" have become hot topics in the nursing world, but they're often misunderstood. Here's a quick breakdown of the differences:

  • 80 by '20 is a call-to-action that requires 80 percent of nurses to hold bachelor's degrees by 2020. This initiative has been put in place by the Institute of Medicine in tandem with the Robert Wood Johnson Foundation.
  • BSN in 10 is a proposed policy that would require new nurses to obtain their BSN within 10 years of entering the field if they wish to continue practicing. The initiative originated with the New York State Nurses Association and has received support from the House of Delegates of the American Nurses Association.

The motivation for initiatives like these is threefold. Proponents hope to see improvements in patient care; increased prospects and longevity in nursing careers; and efficiencies in the ability of healthcare facilities to manage increasing patient loads.

It hasn't taken long for other healthcare organizations to align with these commitments. Many hospitals may be drawn by the motivation to uphold high standards of patient care and professional development in order to achieve magnet status, while others can't seem to ignore the question, "Do bachelor's degrees really save more lives?"

The link between education & mortality rates

Healthcare organizations and hospital leadership continually recognize the contributions made by nurses of all educational levels. But many have acknowledged reports that suggest qualifications impact mortality rates.

What does the data say?

Studies suggest a correlation between patient mortality rates and the level of education achieved by their nurses. A 2014 study supported by the National Institutes of Health reported a 7 percent decline in patient mortality for each 10 percent increase in the number of nurses who hold bachelor's degrees. Put simply, nurses with more education appear to have better patient outcomes.

The study brought the conversation a step further by comparing patient outcomes with nursing workload. Hospitals in which 60 percent of nurses hold bachelor's degrees and care for six or fewer patients saw a 33 percent decrease in patient mortality when compared to hospitals in which only a third of nurses hold a bachelor's degree and care for up to eight patients.

This suggests a significant decrease in the number of patient deaths for nurses who have more education and also care for fewer patients. The data suggests that healthcare organizations recognize the need to not only increase RN qualifications, but also increase the number of nurses available to care for patients.

The added benefits of earning a BSN

Because many healthcare facilities are prioritizing a bachelor's level education for RN candidates, the number job prospects for nurses with bachelor's degrees has seen a huge surge in recent years.

In fact, Burning-Glass was used to identify more than a million RN job postings from the past year and found that candidates holding a bachelor's degree qualified for 78 percent of them, while diploma and associate degree holders qualified for just 53 percent.1

The prospects are also greatly increased for RNs hoping to progress into advanced nursing positions later in their careers. For example, we examined nearly 100,000 nurse manager job postings from the last 12 months. The data revealed that candidates with bachelor's degrees qualified for 70 percent of the jobs available, while associate degree holders qualified for just 25 percent of them.2

But the job vacancies don't tell the only story here. There is also increased earning potential for bachelor's degree holders. Nurse manager candidates with bachelor's degrees can expect a $7,000 increase in mean annual salary.3

Are BSNs worth more than the hype?

The initiatives in place to encourage more RNs to earn bachelor's degrees are hard to ignore, but there are two sides to every coin. Some professionals are pushing back despite support from leading healthcare organizations. It's a debate that continues to rage throughout the comment streams of nursing blogs across the Internet.

So what do you think? Are there tangible benefits to a nursing workforce with a higher percentage of bachelor's degrees? Is the jump from RN-BSN worth it? Share your thoughts in the comments below!

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Rose_Queen said:
I don't like the whole push to force nurses back into school to complete a BSN later in life. In fact, many in my facility have decided that they will retire early rather than return to school if the facility indeed follows through with the no BSN = no job on 1/1/2020.

If the push for the BSN continues, then the US needs to do it similar to Canada: grandfather in those already licensed or in school, but as of a certain date, the BSN program is the only option. Might help with the projected nursing surplus as well- more school, less people viewing it as a quick path to a decent paycheck. Might also result in better workplaces for nurses as well- fewer nurses competing for jobs, ability to vote with our feet and still find a good job.

I agree. Grandfather everyone in by 2022. After that be like Canada/Europe mandate to be a RN have a four year degree or accelerated bachelors or higher degeee. In addition, make LPN/RPN programs a two year diploma program. That the program allows you to bridge enter into a BSN program as a third year student.

Have any nurse with an associates be allowed to keep their degree and only have the option to work in LTC/Rehab/Outpatient facilities/Doctor offices. BSNs can work anywhere and in hospitals after 2022.

Make community college free!

TheCommuter said:

The wave of nursing's future is away from the bedside. I will attempt to ride that wave for as long as possible, thank you very much!

And that does require at the very least a BSN. Maybe even a higher degree soon. I'm enrolled in a DNP program in something absolutely non-clinical (informatics); although a graduate or doctorate degree is not required now for certain non-bedside jobs, I'm just staying ahead of the game because it will happen sooner or later.

Specializes in SICU, trauma, neuro.
Heathermaizey said:
One of the differences she told us is that my critical care class this semester is actually a 2 semester class in a BSN program. So, they get more time to go a little more in depth into the disease processes as ours is compressed into one semester.

See my BSN program had ZERO critical care class. It had Geriatric, Family, and Public Health nursing classes, plus theory, informatics, research, and managment classes.

Congrats on the job offer!!

TheCommuter said:
Jobs in acute care are seriously overrated. Everyone (and their mommas) can have those acute care hospital jobs. Meanwhile, the rest of us can enjoy non-hospital jobs that involve less stress, more money, and optimal working conditions.

The wave of nursing's future is away from the bedside. I will attempt to ride that wave for as long as possible, thank you very much!

However, there are some of us that have tried working outside of the hospital when we were eventually told we were no longer good enough to do the job that we had been doing for over a decade and weren't happy with what was available.

Going into LTC was a $8/hr paycut for me and the stress was 10x worse than at the hospitals that I have worked in the past (it took crappy staffing to a whole new level). Home care was a $10/hr cut and although it was definitely very low stress, I'm left broke and bored.

I had a work from home job doing quality review third party for health insurance companies that I actually liked and was okay with the paycut...and then ObamaCare came about and the company tanked 2 weeks into my maternity leave. Wanting to be with my daughter and keep her out of daycare before she started school left a 9-5 office job out of the picture. The shifts in the hospital worked best for what I wanted (2 12/hr shifts on the weekend) and was something I had done for years and actually liked (most of the time). 15 years into my career as a nurse I'm finishing my RN so that I can go back and have already started looking into where I should apply in the next few months to complete the BSN because the nurses that I have done my clinicals with are either BSNs or ADNs currently enrolled in a BSN program because they had been told that if they wanted to stay employed there in the next few years that they would need to get it.

I'm sure there are many people that want nothing to do with acute care. I was only stating what I have noticed for those of us who do want to work in that area. I started out in a hospital and years later found out I would have to go through a bunch of school I had not planned on in order to stay there.

Specializes in Geriatrics, Home Health.
TheCommuter said:
Jobs in acute care are seriously overrated. Everyone (and their mommas) can have those acute care hospital jobs. Meanwhile, the rest of us can enjoy non-hospital jobs that involve less stress, more money, and optimal working conditions.

The wave of nursing's future is away from the bedside. I will attempt to ride that wave for as long as possible, thank you very much!

Unfortunately, at least where I live, most non-bedside jobs require acute care experience, and hospitals will only hire BSNs.

Specializes in Pediatrics, Emergency, Trauma.
WCSU1987 said:
I agree. Grandfather everyone in by 2022. After that be like Canada/Europe mandate to be a RN have a four year degree or accelerated bachelors or higher degeee. In addition, make LPN/RPN programs a two year diploma program. That the program allows you to bridge enter into a BSN program as a third year student.

Have any nurse with an associates be allowed to keep their degree and only have the option to work in LTC/Rehab/Outpatient facilities/Doctor offices. BSNs can work anywhere and in hospitals after 2022.

Make community college free!

I didn't mean to like this-entirely.

I think with the more experienced ADNs should have full reign on where they work-they have the competency that would rival a new BSN prepared nurse

LadyFree28 said:
I didn't mean to like this-entirely.

I think with the more experienced ADNs should have full reign on where they work-they have the competency that would rival a new BSN prepared nurse

Darn tootin'.

Specializes in Critical care.

I've also questioned the interpretation of the data the IOM made which led them to 80 by 20.

As already noted above, the mortality was skewed by the skill mix of the nurses in the study (lots of diploma or adn experience before bsn) and the type of hospital that tends to draw higher bsn prepared nurses. We already know teaching hospitals enjoy better pt outcomes, and also attract higher percentages of bsn nurses by nature. Therefore, I'm not aware of evidence that the researchers controlled for the independent variables experience and hospital makeup.

Had to get the BSN to be a school nurse in my state. Waste of time and money. The CSN classes were worthwhile because they taught me special Ed stuff and 504 stuff. But the BSN was worthless.

I'm in a BSN program at a local university. The extra courses teach nothing but useless, fluffy nursing theories that in no way will make me a better clinician. Our class always says that a BSN stands for BS+nursing classes

Specializes in Critical Care.

While I get 's desire to sell their $47,000 RN to BSN program, it is a bit ironic that one of the supposed advantages of a BSN is a better understanding of statistics and research, and yet they mangle statistics to try and sell their program.

While I'd love to believe that bachelor's was undeniably worth the extra money compared to an ASN, there is no current evidence to support that. The Aiken research the article refers to on the effect of BSN staff proportions on outcomes compared BSN nurses to nurses who graduated from various types of programs going as far back as the 70's. If non-BSN programs have not changed significantly going back to the 70's then this would be an accurate comparison of current ADN and BSN programs, but of course that's not the case. Either due to state mandates or competitive necessity, more and more ADN programs have been required to adopt the curriculum of their partnering BSN program, so while Aiken's research makes for an interesting historical look at the difference between these programs that no longer exists, it's of little relevance to the newer generation of ADN programs.

As for the ability to find a job, Rasmussen refers to the language used in job postings, which often has nothing to do with who they will actually hire. The last two facilities I've worked at had "BSN required" job postings, yet we hired more than half ADNs. A more accurate measurement would be actual job placement, which the BLS studies regularly and the last data from them I'm aware of showed only a 4% decrease in the likelihood of an ADN grad having a job in nursing at 6 months compared to a BSN.

Specializes in Emergency Medicine.

Penn, which in my opinion sets the bar in the healthcare spectrum, has done a research study that directly correlates a decrease in mortality when the nurse is BSN prepared. Robert Wood Johnson has done a study on better patient outcomes with a BSN prepared nurse at the bedside.

I work for a very large healthcare system, our "mother" hospital only hires BSN prepared and that is one of the reasons they consistently rank at the top of best hospitals. They also encourage research from nurses at the bedside- because that is what will make huge impacts in the medical community. Nurses publishing this research will NOT be taken seriously in the medical community without a degree to back them. How can we "sit" at the big boy table and be taken seriously as clinicians if we as a profession don't continue to evolve through education and commit to the success educated nurses bring to our profession? We could make so many changes and impact patient outcomes so much more if we push for furthering our education. Where is the standard? Every other medical profession has a "line in the sand" so to say, about what at minimum is required to succeed- and those minimums are more than a bachelors degree. I think setting a BSN standard, is the very least we could commit to as a profession.

My hospital will also pay 100% for a nurse to obtain a BSN. It's foolish to not take advantage of that. However, it's no ones responsibility but ones own, to pay for education if you wish to better yourself and advance in your profession.