Do I REALLY need a BSN?

Nursing Students ADN/BSN

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Hi. I just graduate with my ADN as a second career. Before that, I was full time mom and before that I was an attorney (yeah, weird, I know). So, I'm hearing here and there that if I want even a chance at a hospital residency position (I want to be in the ICU one day), I need a BSN. But I keep thinking, "really? I already have a B.A. and a J.D.!" My original plan was to work, gain experience, and then go for a masters in a clinical specialty. But now, I'm now sure. I just can't believe that all my other experience and education doesn't count, especially when the BSN program really doesn't have any clinical component -- it's just more research and writing. I'm working in a really well run SNF, so I'm not really unhappy, but my dream has been to be in the ICU. I'll do what it takes but I'd like to know what other people have heard before I jump back into school. Thanks!

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
In order to get an ADN at a community college, you need to take at least two semesters of prerequisites (including humanities and sciences), and four semesters of nursing classes. That is easily three-years-worth of classes if you take off the summers. AA/AS degrees generally require 60 credit hours, but an AS in nursing generally requires 72.

*** I am sure that's true at many colleges but not in others. For example here in Wisconsin the technical college's ADN programs have no college class prerequisites. They can be, and very often are, completed in 2 years taking the summer off. That's how we end up with a bunch of 19 & 20 year old RNs each year. A few years ago I precepted a new RN who was 18 at the time she was in the critical care nurse residency. (she was outstanding BTW and graduated from CRNA school last month at the age of 24)

Welcome to Southwest Tech

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*** I am sure that's true at many colleges but not in others. For example here in Wisconsin the technical college's ADN programs have no college class prerequisites. They can be, and very often are, completed in 2 years taking the summer off. That's how we end up with a bunch of 19 & 20 year old RNs each year. A few years ago I precepted a new RN who was 18 at the time she was in the critical care nurse residency. (she was outstanding BTW and graduated from CRNA school last month at the age of 24)Welcome to Southwest Tech
That's not true at all the WI tech schools. I live in SE Wisconsin and attend one of the tech schools and you can't petition for clinicals until you have completed chemistry, math, and A&P 1 and 2 and taken the TEAS test. You also need microbiology, psychology, sociology, communications, English and a few other classes in addition to your nursing classes and those classes must be done before 1st or 2nd semester I believe. Also there is such a long waiting list now that no one starts right away. I applied in December 2009 and my number just now came up to start in January.
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The IOM based its recommendation of 80% BSN nurses by 2020 on the highly flawed 2003 Aiken study which used gross estimations, incomplete data, and much self-affirming validity to only IMPLY the more BSN nurses equate to lower mortality rates in hospitals. The study used a template for a previous study on nurse to patient ratios and mortality rates. Then they cut and pasted, added and subtracted data and made estimations. Then they ran all of this manipulated data through a statistical regression model to see what MIGHT happen if they was a 10% increase of BSN nurses. They did not test real nurses in real hospital situations.

To even suggest a change in nursing policy based on this study model is absolute stupidity.

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The IOM based its recommendation of 80% BSN nurses by 2020 on the highly flawed 2003 Aiken study which used gross estimations, incomplete data, and much self-affirming validity to only IMPLY the more BSN nurses equate to lower mortality rates in hospitals. The study used a template for a previous study on nurse to patient ratios and mortality rates. Then they cut and pasted, added and subtracted data and made estimations. Then they ran all of this manipulated data through a statistical regression model to see what MIGHT happen if they was a 10% increase of BSN nurses. They did not test real nurses in real hospital situations.

To even suggest a change in nursing policy based on this study model is absolute stupidity.

Bumping a six year old thread just to push your animosity toward the Aiken studies?

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Just telling the truth. And you and those who think like you have every right to be afraid. As opposed to a few years ago, many nurses have or will be retiring soon; and will not be afraid to talk now. I have contacted the Gov. of NY as well as well as news stations and will continue to do so until I get the story pushed. We're losing too many good, experienced nurses who will not be pushed or for financial reasons will not go into debt for another $15,000 -$25,000 to write APA papers on nursing theory and get no additional information that will better help them heal patients.

And people are sick of the ever-increasing student loan debt from over-priced four-year universities. If someone can't learn the art and science of nursing in a 2 year associate's or 3 year diploma program, then they probably shouldn't be4 nurse. The 2 and 3 year5 programs are more then adequate; the rest is acquired through experience and by learning from those who have more experience. Those are the nurses we're losing; unfortunately.

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I'm not afraid (what on earth would I be afraid of?), and none of that is "the truth," it's your opinion.

So, how's the big media expose' coming? You've supposedly been working on it for a few years now; I haven't seen anything in the media, other than you continuing to post here to flog the same opinions over and over.

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I know you are afraid. It's why you crawl out of your little cubby-hole, along with the other one from Boston to try to refute it when I write about it. Everything I said about the Aiken study was true and in the study itself; which I'm starting to doubt you even read through. You and others are afraid of the backlash when nurses start to realize they went into debt for thousands unnecessarily. I told you, I met with one of the big 3 NBC, CBS, ABC a couple of years ago. The producer wanted more nurses who would speak out. And now that more are leaving nursing rather than go into to debt for something that doesn't do squat for patient care, you're worried more will be willing step in and speak. If you though I was a kook, you wouldn't bother to respond. By the way, how's your coffee and doughnuts today. Good day my friends.

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Specializes in Adult Internal Medicine.
Everything I said about the Aiken study was true and in the study itself; which I'm starting to doubt you even read through.

You were called out for posting "quotes" from the study which do not appear anywhere in the study.

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I know you are afraid. It's why you crawl out of your little cubby-hole, along with the other one from Boston to try to refute it when I write about it. Everything I said about the Aiken study was true and in the study itself; which I'm starting to doubt you even read through. You and others are afraid of the backlash when nurses start to realize they went into debt for thousands unnecessarily. I told you, I met with one of the big 3 NBC, CBS, ABC a couple of years ago. The producer wanted more nurses who would speak out. And now that more are leaving nursing rather than go into to debt for something that doesn't do squat for patient care, you're worried more will be willing step in and speak. If you though I was a kook, you wouldn't bother to respond. By the way, how's your coffee and doughnuts today. Good day my friends.

I still don't understand why you are so convinced that I, or anyone else, am "afraid" about any of this. I have no personal stake in this issue either way. I just hate to see anyone mangle science as badly as you do. I find it embarrassing for nursing as a group.

And what's the obsession with "coffee and doughnuts" about? I see you keep making references to that, and don't get what your point is.

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The information about using gross estimations and then and then making an estimation about what MIGHT happen if there was a 10% increase in BSN nurses are buried in the body of the study. I posted that before. Funny, one of my former nursing professors , who did have a doctorate left my nursing school to help run a dept at a four year nursing school. She had always been one to defend 3 year nursing diploma education. But when I went to see her at the university, she did a complete turn-around and even quoted a statement from the March 2011 "It's Academic" article in Nursing Spectrum. I understand she had to tow the company line and we both nodded to each-other as I told her I understood. I understand it's a business. And I would respect those pushing it if they would come out and admit instead of this phony nonsense about elevating the profession. I also believe the push for PTs and Pharmacists was purely money-driven. I believe there are plenty of excellent PTs and Pharmacists out there with Master's degrees and years of experience. But I am not in those professions and can't fight for them. If I had solid proof that taking courses such as "Sociology of Nursing", "Theoretical Foundations of Nursing" would help heal patients, then I would agree that having a BSN could help patients. This may be hard for you to believe, but I am about helping people and doing what's best to accomplish that. My mother died a few months ago because I believe the staff did not recognize the early signs of Sepsis. When I visited her the first day and saw her vital signs, I asked if she was being evaluated for Sepsis protocol. They just told me they were working within hospital parameters. How about a BSN program to teach nurses how to better recognize early signs of sepsis, diabetes complications or new wound healing methods or new methods to accelerate healing and speed recovery. Give me those things instead of just writing more APA format papers and I'll agree that a BSN is worthwhile and needed.

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Specializes in Adult Internal Medicine.
The information about using gross estimations and then and then making an estimation about what MIGHT happen if there was a 10% increase in BSN nurses are buried in the body of the study.

I am not sure you understand the purpose of the study. The study built on previous studies which had identified that improved staffing levels, improved work environments, and increased nursing education were all associated with improved patient outcomes (lower mortality). The design of this study was to take the outcomes data from a large number of hospitals and patient encounters and use that data to build a model. The model could then be used to predict the effect on patient outcomes if the modifiable risk factors were adjusted (staffing, environment, education) while keeping everything else the same.

Funny, one of my former nursing professors , who did have a doctorate left my nursing school to help run a dept at a four year nursing school. She had always been one to defend 3 year nursing diploma education. But when I went to see her at the university, she did a complete turn-around and even quoted a statement from the March 2011 "It's Academic" article in Nursing Spectrum. I understand she had to tow the company line and we both nodded to each-other as I told her I understood. I understand it's a business. And I would respect those pushing it if they would come out and admit instead of this phony nonsense about elevating the profession.

Or maybe, rather than her being involved in a multinational conspiracy from "BigNursingAcademia" she read the data and changed her mind. And maybe your assumption that support for 3-year diploma is mutually exclusive to also supporting advancing nursing education: it's not. These studies (and Aiken's are only a part of it) suggest that more education makes individual nurses better nurses: I feel like you think these studies suggest that nurse A, AN is a worse nurse than nurse B, BSN and they absolutely don't.

If I had solid proof that taking courses such as "Sociology of Nursing", "Theoretical Foundations of Nursing" would help heal patients, then I would agree that having a BSN could help patients.

There are numerous studies across many countries that have shown consistent results.

This may be hard for you to believe, but I am about helping people and doing what's best to accomplish that. My mother died a few months ago because I believe the staff did not recognize the early signs of Sepsis. When I visited her the first day and saw her vital signs, I asked if she was being evaluated for Sepsis protocol. They just told me they were working within hospital parameters. How about a BSN program to teach nurses how to better recognize early signs of sepsis, diabetes complications or new wound healing methods or new methods to accelerate healing and speed recovery. Give me those things instead of just writing more APA format papers and I'll agree that a BSN is worthwhile and needed.

I am sorry about your mother.

I would argue that education does help. While going from and ADN to a BSN might not directly teach a specific thing (like early recognition of sepsis) it does (in theory, and supported by data) contribute non-directly. Increasing nursing education does many meaningful things for the profession including increasing nursing research, critical clinical thinking, EBP, etc which sum up to improved outcomes, and in the end, your mom maybe could have been in that reduction in mortality the studies have suggested.

We should improve nurse staffing levels. We should improve nurse working environments. We should improve nursing education. These are all modifiable risk factors or patient mortality that nursing can impact.

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I completely agree about nurse staffing levels being a factor in mortality rates. But the topics of staffing levels and nurse education and their effect on mortality rates are mutually exclusive and should have been examined in that way if the authors really wanted to imply that RN education levels affected patient outcomes. That is my whole contention with the study. And it was immediately trumpeted out as Gospel truth by those with pro-BSN agendas. I'll even give the authors some credit as to maybe they didn't intend for the study to be used in that way. However, when they saw how their research was being used, it would have been ethical to come and and it was only an estimation as to what might happen if there were a 10% increase in BSN hospital nurses. But they kept quiet. I can not trust based on just their say-so that they completely and objectively factored all impertinent data while they factored in only relevant data. It was not original research. I also must ask why they didn't want to take the time to do a completely original study on nurse education levels. And then looking at who supported the study, I question as to whether it was truly unbiased. Don't know if Aiken is still teaching classroom nursing courses, but I highly doubt she would have accepted a paper from a student that was built on a previous paper handed in. I spoke with a couple of Univ. of Penn nurses and they didn't even know who she was.

You seem to like the word conspiracy. I really haven't heard the word used much since Oliver Stone's JFK movie. But I am merely saying that there are multiple organizations benefiting from people being driven back to colleges and universities. It's not conspiracy; it's business.

Good day.

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