Entry into Practice (Part 2) - Baccalaureate Programs in Nursing (BSN)

VickyRN, MSN, DNP, RN

Registered nurses graduating with a baccalaureate degree make up 30.5% of new nursing graduates in the US. These graduates take the same nclex-rn licensure examination as diploma and ADN graduates. Forty percent of the entire national nursing workforce currently hold a baccalaureate nursing degree or higher.

Three components comprise the BSN curriculum: liberal arts education, nursing practice, and electives. The liberal arts portion includes courses in the sciences, general education, humanities, and social studies. The nursing courses build upon these prerequisites in the curriculum. Each course is arranged in an orderly sequence. Blocks of courses must be taken concurrently and passed successfully with at least a "c" for the learner to proceed to the next level of complexity.

Bsn programs differ from adn programs in course load, content, and duration. The typical BSN curriculum consists of 128 to 133 semester hours, as opposed to the 70-80 semester hours required for the adn. The baccalaureate option provides a broader background of knowledge with additional coursework such as research, leadership, pathophysiology, health assessment, organic chemistry, informatics, and community or public health nursing. These additional courses enhance the learner's professional development and equip graduates with a better understanding of the complex political, cultural, social, and economic issues that influence patient care and health care delivery systems. Bsn programs are typically housed in senior colleges and universities as compared to the community college setting for the adn.

Bsn graduates generally have better job opportunities than their adn counterparts. Some facilities, such as the veterans administration or magnet hospitals, prefer BSN grads. An increasing number of specialty areas require the BSN degree for practice and as part of the certification process (such as the ANCC). These areas include community or public health nursing, education, research, nursing informatics, management, leadership, and care coordinator in a variety of environments.

The BSN curriculum also provides graduates with the necessary foundation for graduate study in nursing including nurse practitioner, nurse midwifery, and CRNA programs.

Bsn degree programs typically require 2 years of arts and sciences as the foundation for 2 years of nursing coursework. Students can then be admitted as juniors into the nursing program after completing the required prerequisite courses.

Some schools introduce students to nursing content during the first 2 years, but these types of programs are less common. An example is the University of Pittsburgh; this school of nursing has nursing content integrated throughout the entire 4-year curriculum program.

Baccalaureate nursing education originated in the University of Minnesota in 1909. This rudimentary program followed the diploma model and did not offer a true college degree. Over the next decade, 15 similar programs were implemented in other universities. It was not until 1924 that yale university offered a baccalaureate degree in nursing. This was a 28-month program with scientific studies, clinical work, and an academic degree meeting the rigorous standards of the university. The yale school of nursing became the first autonomous nursing program with its own dean, budget, faculty, and professional nursing degree. In 1923, a bona fide 4-year BSN degree program opened at western reserve university (now case western reserve university). This nursing school continues as a leading school today.

The BSN programs that succeeded these early prototypes took 5 years to complete, with the first 2 years in liberal arts and sciences, and then 3 years to finish the nursing courses. These formative programs eventually evolved into the contemporary 4-year model.

The number of colleges and universities offering BSN degree programs has dramatically increased since these humble beginnings a century ago. Today, there are nearly 700 baccalaureate nursing programs across the nation.

The creation of BSN programs was an important milestone in nursing education, similar to Montag's impetus for associate-degree nursing. Nurse leaders of the day, as chronicled in the Goldmark report of 1923, believed education for the practice of professional nursing must have a substantial knowledge base and should take place at the collegiate or university level. In the Goldmark report, Goodrich, nutting, and wald proposed that nurses would be more effective in their roles if they were able to draw from foundational knowledge in the behavioral and biological sciences.

Clinical practice for baccalaureate students complements classroom instruction and involves placements in a variety of health care settings and specialties such as hospitals, long-term care facilities, home health, public health, early childhood enrichment programs, schools, clinics, and other community agencies. I have two clinical groups this upcoming semester: one for second-semester students on the pediatric floor and another for first-semester students in the rehabilitation unit.

Some BSN programs offer nurse extern programs during the summer between the junior and senior years. these excellent learning partnerships are intense 10 to 11-week courses for advanced nursing students at area hospitals. Students are assigned an onsite clinical nurse preceptor, with whom they perform bedside care on a 1:1 basis. The preceptors work closely with the program to ensure that students achieve their clinical objectives and course requirements.

In order to better meet the needs of the service area, some BSN programs employ a "2-plus-2" articulation partnership with neighboring community colleges. This allows for a seamless transition from one program to the other. Students complete their first 2 years in an ADN program and then complete the last 2 years of the BSN in the university program.

There are two recognized accreditation agencies for baccalaureate nursing programs: the NLN (NLNAC) and the AACN (CCNE).

Variants of BSN programs include accelerated BSN and RN to BSN programs. These options will be discussed in a later blog. please stay tuned!

References

Blais, K. K., Hayes, J. S., Kozier, B., & ERB, g. (2006). professional nursing practice: concepts and perspectives (5th ed.). Upper Saddle River, NJ: Pearson Prentice Hall.

Cherry, B., & Jacob, S. R. (2005). Contemporary Nursing: Issues, trends, & management (3rd ed.). St. Louis, MO: Mosby Elsevier.

Liddle Noodnik · Aug 11, 2009

Nice job! thanks!

miss81, BSN, RN · Aug 11, 2009

Really informative! My BN program in Canada was 4 years of nursing in the University setting with electives/arts/sciences mixed in. I had clinicals each semester along with courses and clinicals every summer as well. My final semester was "independent practice" where we worked as a floor nurse with no classes, only a discussion group. I know ppl say that BN's (or BSN) get less clinical, but in my 4 years there was never a semester that I didn't have clinical along with my classes. It was a great program!

VickyRN, MSN, DNP, RN · Aug 11, 2009

Really informative! My BN program in Canada was 4 years of nursing in the University setting with electives/arts/sciences mixed in. I had clinicals each semester along with courses and clinicals every summer as well. My final semester was "independent practice" where we worked as a floor nurse with no classes, only a discussion group. I know ppl say that BN's (or BSN) get less clinical, but in my 4 years there was never a semester that I didn't have clinical along with my classes. It was a great program!

Very interesting. Except for a few provinces or territories (such as Quebec), the BSN is the entry level in Canada. I gather from your post that you had nursing content and clinical experiences interwoven throughout your 4-year program, from the very first semester on?

psychonaut · Aug 11, 2009

As far as entry-to-practice goes, I find the ND concept very interesting. Obviously an experiment that didn't pan out, but certainly a unique way to approach the education of nurses from the bottom-up, with advanced health policy education built into the education. I have found it difficult to round up much detail on the programs as they existed, but it seems some of the concepts could be integrated into the BSN and etp MSN curricula.

miss81, BSN, RN · Aug 11, 2009

Very interesting. Except for a few provinces or territories (such as Quebec), the BSN is the entry level in Canada. I gather from your post that you had nursing content and clinical experiences interwoven throughout your 4-year program, from the very first semester on?

Yes, our Bachelor of Nursing is pretty much the same as the Bachelor of Science in Nursing. I have heard so much stuff about the BN program not having the science and research component because it is not a part of the science faculty. Absolutely not true! Our University had a separate Nursing school (together with a medical and pharm. schools) that operate autonomously as opposed to being a part of the science faculty. We had many research courses (believe me... many), biochem, microbiology, psychology, statistics, English etc. as well I did some philosophy, kinesiology, and womens studies courses as my electives. Along with the nursing courses and clinicals interwoven throughout the program. The Canadian Nurses Association and its provincial and territorial counterparts agreed that, by the year 2000, everyone entering the profession should have a bachelor's degree in nursing. My program ensured all Newfoundland and Labrador nursing graduates will now meet this goal. This BN gives you the basics of nursing as well as additional studies in health promotion, nursing leadership, health assessment, research, community health nursing and related academic areas. Your BN gives you many career and graduate study opportunities.

miss81, BSN, RN · Aug 11, 2009

As far as entry-to-practice goes, I find the ND concept very interesting. Obviously an experiment that didn't pan out, but certainly a unique way to approach the education of nurses from the bottom-up, with advanced health policy education built into the education. I have found it difficult to round up much detail on the programs as they existed, but it seems some of the concepts could be integrated into the BSN and etp MSN curricula.

Ok, this might make me see stupid but what is "ND program"?

VickyRN, MSN, DNP, RN · Aug 11, 2009

Yes, our Bachelor of Nursing is pretty much the same as the Bachelor of Science in Nursing. I have heard so much stuff about the BN program not having the science and research component because it is not a part of the science faculty. Absolutely not true! Our University had a separate Nursing school (together with a medical and pharm. schools) that operate autonomously as opposed to being a part of the science faculty. We had many research courses (believe me... many), biochem, microbiology, psychology, statistics, English etc. as well I did some philosophy, kinesiology, and womens studies courses as my electives. Along with the nursing courses and clinicals interwoven throughout the program. The Canadian Nurses Association and its provincial and territorial counterparts agreed that, by the year 2000, everyone entering the profession should have a bachelor's degree in nursing. My program ensured all Newfoundland and Labrador nursing graduates will now meet this goal. This BN gives you the basics of nursing as well as additional studies in health promotion, nursing leadership, health assessment, research, community health nursing and related academic areas. Your BN gives you many career and graduate study opportunities.

Sounds like a wonderful program :)