Do I REALLY need a BSN?

allnurses Guide · Sep 19, 2012

Well I know *I* would rather have a floor full of brand new grad 23 year old BSN nurses taking care of me over 15 year veteran ASN's and LPN's...how bout you?

Because there are more new-grad BSNs than ASNs?

Guest343211 · Sep 19, 2012

This whole BSN push at this time in the economy - really saddens me. It is such an oximoron. With thinking and bandwagon soapboxes like this- nursing will never add credibility to the profession. I can understand targeting the already degreed and "working" experienced nurse for the APN-NP's but not the RN's and LPN's who are just barely making ends meet on partime, agency, per diem and temp position work and/or unemployment to foot the bill of this expensive endeavor. And locking them out of gainful employment so they will never economically recover. This is just plain wrong on so many levels.
There is no economic turnaround with this mentality!! It doesn't take a MBA to figure that out.

The hospitals have semi-frozen or periodically thawed job openings for nurses; b/c this is what is dictated to them in this particular economy. Another factor is what the changes in healthcare will end up costing the hospital-employers, so it's another reason to limit hiring, since they have to cover a percentage of benefits. As I said before, they can also pay new grad, even BSNs, a lot less than what they would need to pay experienced nurses--regardless of the degree they have. So if they are to fill some of the slots that fiancial advisers will allow them, the CNOs' attitude is kill two birds with one stone. Make it only BSN--unless they are really are in extreme-need mode in a particular area. They can go and take a few high GPA new BSNs and meet the goal of increasing BSN nurses within the institution, and they don't have to pay them what they would have to pay experienced nurses. If they are really tight for experienced nurses, again, they will first take the experienced nurses with BSNs or higher. But their best bet, money wise$$$$, is to hire a new BSN. They also believe the newbies won't give them any guff about scheduling, weekends, and nights rotations.

Also, I think part of this is about holding down nursing salaries as well. From a fiscal perspective, you can see the sense in it. They are struggling too, plus reimbursements are down.

I am NOT agreeing--I'm saying I see where they are coming from.

Also, think about the fact that if you hire RNs that already have BSNs, you don't have to concern yourself with shelling out tuition reimbursements, except perhaps for those that pursue graduate degrees. Sure they limit the tuition reimbursement, but they also want to bet the statistical probability that most won't go on for graduate degrees. (This is from the hospital's $$$$ perspective, not the nursing profession's academic agenda.)

Most young BSNs are going to be looking into marriage and having children. Most will not be pursuing MSNs, at least not right away. If, however, you hire RNs w/o BSNs, knowing that see the push in nursing is that in order to get anywhere, they must at least have a BSN (supervisor, manager, research, other positions that are not purely clinical or bedside) why they will be more likely (in numbers) to use tuition reimbursement to complete the undergrad. Now on top of paying experienced nurses more, you risk having to shell out more tuition reimbursement. More nurses will take advantage of tuition reimbursement for BSN than for graduate education--overall.

Money is definitely a factor, but what is going on is like a collision of forces.

What they will say is "We can only hire so many (which has truly been cut down in FTEs and PTEs since 2007-2008). So we will hire the best candidates. And this where many of us, regardless of our level of education, would disagree.

The best candidates are those that have strong experience in the particular areas and have had time to develop confidence and sound clinical judgment. I agree with the poster below. . .of course anyone who has really worked in clinical nursing knows that usually, the better candidate is the one with the experience, insight, and clinical judgment--regardless of whatever degree they hold.

When new grad BSNs (and they need jobs and experience too), get positions over say diploma or ADN nurses with strong experience, well, it's all nonsense--it's not about getting the best candidate--at least not clinically. It's about the institution getting the bigger credentials for their buck. And definitely Magnet has influence over this, as is seen in the article I posted.

It's also here:

[NEW SOE

The source of evidence reads: "Provide an action plan and set a target, which demonstrates evidence of progress toward having 80% of direct care registered nurses obtain a baccalaureate degree in nursing or higher by 2020."

The source of evidence will be effective June 1, 2013.

Organizations submitting documentation anytime on or after June 1, 2013, regardless of the application date, will be expected to address the SOE. The SOE will not be scored during the period of June 1, 2013 - June 1, 2015. The Commission on Magnet will review the results of the source of evidence, making a decision on the scoring prior to June 1, 2015. Your action plan should be included as the last item in Organizational Overview.]

Magnet Recognition Program® FAQ: Data and Expected Outcomes - American Nurses Credentialing Center - ANCC

The above quote is about 1/4 down the page.

So, I ask you; if you want to get to Magnet's action plan of 80% BSNs in house, and you already have RNs in your system that are not, why would you not want to only hire BSNs?

Magnet recognition is a selling point--and the institution wants to present its best at meeting Magnet's action plan. Instead of worrying about paying for more ADN's to continue to BSN, you simply hire new BSNs. On the face of it, the plan makes sense, even though we all know there are ultimate flaws in it.

Guest343211 · Sep 19, 2012

Because there are more new-grad BSNs than ASNs?

I think her point (note the eyeroll) was that as a patient, like most of us, she'd prefer to go for the veterans or experienced nurses.

Of course we all know it's not the length necessarily, but the quality of the person's experiences and their dedication to growth and efficacy over those years of experience. We have all seen experienced nurses that leave a lot to be desired. But in general, definitely the clinical experience makes the difference.

Guest343211 · Sep 19, 2012

There is no reputable study that proves patient outcomes are better due to whether or not one holds an ADN degree or a BSN degree at the time the question is asked. There are quite a few "associated with" articles, lots of "surveys", etc. The question is simplistic and becoming more so as people get their BSNs in a variety of ways with a wide range of prior experience (a factor not included in Linda Aiken's 2003 study of post-op surgical patients btw) to take a BSN who was an and ADN for 20 years first and compare it with one who just graduated.
I don't understand why people think the AACN is objective, either. They bend over backwards to discredit any research findings that don't fit with their talking points. One could only wish they brought such energy to scrutinizing the studies they claim prove the better outcome point.

Not at all saying I disagree with you. Just saying what they are using and how they are running with it.

PMFB-RN, RN · Sep 19, 2012

I did my RN to BSN program at a local, well respected state university. Not a dipiloma mill but a real state university with a school of nursing and a variety of nursing programs from generic BSN to DNP. Several of us ICU, ER and rapid response RNs from my hospital did it together. All of us were already CCRN, or CEN certified and very experienced critical care RNs with vast amounts of training and experience behind us. I feel like I got dumber going through the program. It was patheticaly easy and the level of discourse was very disapointing. None of the instructors seem to know much about real nursing. I feel that obtaining the BSN was actually a hinderance for me. Forexample due to having to be in class I missed a lot of very good training. Fundamentals of Critical Care Support class for example(SCCM - Society of Critical Care Medicine). ATCN (advanced trauma nurse core corse, step up from TNCC) for another.

The BSN hasn't beinifited me in any way I can tell. However I hope that if I ever seek another job it will be a benifit. On the plus side it was 100% paid for by my hospital and I even got paid to do much of my school work.

allnurses Guide · Sep 19, 2012

I think her point (note the eyeroll) was that as a patient, like most of us, she'd prefer to go for the veterans or experienced nurses.
Of course we all know it's not the length necessarily, but the quality of the person's experiences and their dedication to growth and efficacy over those years of experience. We have all seen experienced nurses that leave a lot to be desired. But in general, definitely the clinical experience makes the difference.

I agree that clinical experience is important, unlike most people posting here, I also think that experience and education are to separate entities that are both valuable and not directly comparable.

I am a MSN that is continuing a DNP when all of my colleagues think its a joke because I believe that education is important for the profession.

Do you respect/trust an attending more than a M1? They have both education and experience in their favor.

allnurses Guide · Sep 19, 2012

Not at all saying I disagree with you. Just saying what they are using and how they are running with it.

I know. It's really tangential to the topic anyway, because I would still answer the question "do you really need a BSN?" with a yes. We need to look at it from the employer's perspective, whether it makes sense to us or not. For maximum potential and job flexibility, if at all possible - go for the BSN right away. One of the things I will always appreciate about entering nursing when I did was the ability it gave me to move wherever I wanted and know I would have a job - pretty cool when you're in your twenties with no kids. :) You need a BSN to do that, now.

PMFB-RN, RN · Sep 19, 2012

Magnet recognition is a selling point

*** For who? To potential patients? For luring RNs to work there? My observation is that patientsd have no idea what Magnet is and don't care. As for nurses, many many I know see Magnet as a con when considering working at a particular hospital. I am happy I managed to obtain a position as a good non-Magnet hospital and am even happier to no longer be subjected to the Magnet recert process. Being told EXACTLY how to respond to surveyors questions with vauge threats if we fail to tow the party line during the re-cert process gets old. Waching the hospital jump to implament such things as an RN practice counsil or "shared governance" only to see them done away with immediatly after obtaining Magnet is demoralizing.

allnurses Guide · Sep 19, 2012

I did my RN to BSN program at a local, well respected state university. Not a dipiloma mill but a real state university with a school of nursing and a variety of nursing programs from generic BSN to DNP. Several of us ICU, ER and rapid response RNs from my hospital did it together. All of us were already CCRN, or CEN certified and very experienced critical care RNs with vast amounts of training and experience behind us. I feel like I got dumber going through the program. It was patheticaly easy and the level of discourse was very disapointing. None of the instructors seem to know much about real nursing. I feel that obtaining the BSN was actually a hinderance for me. Forexample due to having to be in class I missed a lot of very good training. Fundamentals of Critical Care Support class for example(SCCM - Society of Critical Care Medicine). ATCN (advanced trauma nurse core corse, step up from TNCC) for another.
The BSN hasn't beinifited me in any way I can tell. However I hope that if I ever seek another job it will be a benifit. On the plus side it was 100% paid for by my hospital and I even got paid to do much of my school work.

This is a great example of the need for quality nursing educators.

redhead_NURSE98!, ADN, BSN · Sep 19, 2012

This is a great example of the need for quality nursing educators.

Yep, it makes me nervous when the instructors of one of the local Vanderbilt Graduate Residency feeders are younger than me (upper 30's).

Guest343211 · Sep 19, 2012

I agree that clinical experience is important, unlike most people posting here, I also think that experience and education are to separate entities that are both valuable and not directly comparable.
I am a MSN that is continuing a DNP when all of my colleagues think its a joke because I believe that education is important for the profession.
Do you respect/trust an attending more than a M1? They have both education and experience in their favor.

I am not against increasing education or the agenda. What I have a problem with is how it is being done.

I disagree about education and experience. One does not develop sound clinical insight without coupling both, in terms of application. The didactic has to be coupled with the clinical experience and opportunties for application. The experience is the piece that goes with the didactic.

Physicians, in general, go about post medical school education much differently than nursing does. The step process, and the way residency programs are set up speak to this. The attending, in general, has been worked, vetted, and completed STEPS for licensure and board certification in a very specific and more centralized and formalized way. If you are talking med students, well, they usually start clinical rotations in year 3 med school. PGY-1s know they know little to nothing--in terms of real application.

It's not the same comparison. Now, if nursing did use a similiar system for residency--like medicine, for say NP's, in terms of clinical hours, etc, that would be a start.

allnurses Guide · Sep 19, 2012

*** For who? To potential patients? For luring RNs to work there? My observation is that patientsd have no idea what Magnet is and don't care. As for nurses, many many I know see Magnet as a con when considering working at a particular hospital. I am happy I managed to obtain a position as a good non-Magnet hospital and am even happier to no longer be subjected to the Magnet recert process. Being told EXACTLY how to respond to surveyors questions with vauge threats if we fail to tow the party line during the re-cert process gets old. Waching the hospital jump to implament such things as an RN practice counsil or "shared governance" only to see them done away with immediatly after obtaining Magnet is demoralizing.

Is there some significant research showing that mag status hospitals have both better outcomes and patient satisfaction?