Entry into RN Practice: Associate Degree Nursing (ADN)

There are multiple entry levels into the profession of registered nursing. The various entry points are associate-degree in nursing (ADN), bachelor of science in nursing (BSN), diploma nursing programs, and direct-entry nursing graduate programs. These divergent entry levels can be perplexing to students, members of the allied healthcare team, and the general public. In this blog, we will discuss the associate-degree entry level, the most common pathway to registered nursing in the U.S. Specialties Educators Article

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nursgirl

129 Posts

Specializes in Critical Care, Operating Room.

I am entering my last semester in an ADN program and overheard one of the nursing faculty say the other day " the ADN is the only 2 year degree that takes 5 years to get" hahahaha SO TRUE!!!!

It's well worth it though!! I will be done soon and able to work (God willing there's a job for me haha) and I can go on to acheive my BSN while I work... to this very poor college student this was the way to go... I will graduate with NO student loans to pay back!

On the downside... it will have taken me 5 years to complete my 2 year degree LOL =)

VickyRN, MSN, DNP, RN

49 Articles; 5,349 Posts

Specializes in Gerontological, cardiac, med-surg, peds.
Grace Oz said:
I appreciated being able to read this, Vicky, thank you.

I must confess to sometimes being a bit confused with the various levels in the USA. It somehow seems more complicated than here in Australia. ?

Would you like to elaborate more on the various types/ levels of nursing in Australia, Grace Oz? I have found this bit of information concerning nursing in Australia:

Quote

Nurses are classified into two broad categories:

  • registered nurses (who usually have a degree), and
  • enrolled nurses (who usually hold a certificate or advanced diploma).

Registered nurses make up the majority of all nurses.

Although the level of expertise varies within these groups, in general, registered nurses perform more complex medical procedures and hold more responsibility than enrolled nurses. For instance, in most jurisdictions only registered nurses have the authorityotherwise retained by general practicesto administer medications.

There are also other differences between registered and enrolled nurses. In general, registered nurses are more likely to be employed in critical or intensive care and less likely in geriatrics/gerontology; more likely to be employed in acute care hospitals and less likely in nursing homes; less likely to be working part-time; and more likely to work in capital cities, than enrolled nurses.

VickyRN, MSN, DNP, RN

49 Articles; 5,349 Posts

Specializes in Gerontological, cardiac, med-surg, peds.
rwbglock23 said:
Great post. I can testify to almost all of the disadvantages you have listed! It has taken me about 3 years to get admitted into the ADN program that I start in the Fall. Unfortunately this is how nurses are produced at I believe you said 60% per year which means that the majority of the nurses who went for their ADN, could have likely earned their BSN in the same amount of time. For me, weighing my options in the decision of ADN vs. BSN, the flexibility of taking my prerequisite (which were actually my co-requesite) classes at different times of day and one class per semester so I could work full time was the deciding factor.

Thank you for sharing your experiences, rwbglock23. The convenience and flexibility of the ADN is often the deciding factor in students choosing this entry-level degree over the other options. As a matter of fact, this is why I chose the ADN route back in 1993. My local community college was less than 1 mile from my house (at the time). The campus was very small and the system was so much easier to navigate for someone who had been out of college for aeons.

rwbglock23 said:
I intend to work as an RN and continue my RN to BSN at a university once I pass the NCLEX-RN, as I am sure many ADN nurses intend to. Hopefully I won't get stuck in the rut so to speak of just working as a ADN RN.

Good for you. This is what I did. Immediately upon graduating with my ADN (back in 1996) and after securing my first RN staff nurse job, I set about taking pre-req courses towards my BSN. I finally was able to enter an RN-BSN bridge program in 1998, and graduated with my BSN in 1999. This was all done while I was working full-time as a staff nurse. Getting my BSN proved to be an excellent career move, as it opened many doors for me.

rwbglock23 said:
Maybe you can post something on how we go about choosing a specialty within nursing after graduation? I would be curious to know how one would go about becoming a Trauma or Flight Nurse, for example. Maybe you can describe the top 5 most popular and what needs to be achieved to get into those specialties.

Thank you for this suggestion - an excellent idea for a future blog entry ?

VickyRN, MSN, DNP, RN

49 Articles; 5,349 Posts

Specializes in Gerontological, cardiac, med-surg, peds.
Kyla.ann said:
I was wondering if you could go more in depth on the limits of an ADN as far as jobs and advancement. I was under the impression that ADN & BSN's had pretty much the same opportunities.

This is often true for bedside nursing positions.

However, most hospitals prefer at least a BSN for management positions. The same holds true for professional nursing leadership roles, such as academic nurse educator, unit educator, case management, public health, research, school nursing, clinical instructor, and many other nursing positions. Some hospitals (such as Magnet affiliates or the VA system) prefer BSN graduates, which can be pivotal to getting hired in today's very competitive nursing job market. Smaller community hospitals will often allow ADN nurses to occupy management and leadership positions, but with the stipulation that the employee go on to get his or her BSN or MSN while working full-time in the new role.

If you wish to continue your nursing education to advance practice after graduation, you may need your BSN first before you can apply. Some advance practice nursing programs do have ADN-MSN bridge programs, such as nurse practitioner or nurse midwifery. But the very competitive CRNA programs do not.

Hope this answers your question. I graduated with an ADN, but went on to get my BSN. This proved to be a very smart career move for me.

VickyRN, MSN, DNP, RN

49 Articles; 5,349 Posts

Specializes in Gerontological, cardiac, med-surg, peds.
A_Simp said:
Interesting blog! From my own experience, it did take 3 yrs for me to complete my RN - 1 yr for the pre reqs and the other 2 yr for the NSG courses.

I realize there is quite a bit of debate regarding ASN vs BSN but for my particular situation, I all ready have a AS and BS in another field and found the ASN route the most cost effective approach to earning my RN. In my area of the country and hospital there is no $$ difference or distinction unless I am looking to grow into management or education position.

Out of the 30 or so students from my nursing class about 3/4 of us had all ready obtained degrees in other subject areas. One classmate had a MS in guidance, another MS in history and was a teacher. I believe the ASN route is a good option for 2nd or 3rd career changers, who's goal is to getting into bedside NSG. After they are licensed and get their feet wet, they can continue onward with their education, while taking advantage of tuition programs through their employer.

ASN vs BSN is not an accurate comparision because of what I mentioned above about 2nd or 3rd career changers. Most are older, non-traditional students, including myself, offering a diverse skill set and life expierences. In my own case, I was a business consultant for a franshise company and had to develop relationships with franchisees in order to educated them on how to operate all facets of running a sucessful business. In addition, I am a certified, FAA flight instructor and responsible for devolping flight training cirruculm as well as assisting students to develop critical thinking and technical skills in order to obtain their pilot licenses. When you're up in the air flying and there is an emergency or situation, you just can't stop and pull over to work the problem out.

Unfortunately, instead of looking at a person as the "Whole Package" and really seeing all that they have to offer, we are relegated and at times, unfairly judged just by the type of NSG degrees we hold - ASN or BSN.

I taught in both types of programs - ADN and later BSN. I found what you relate to be true. The "typical" student in an ADN program is "non-traditional" - older, with vast life experiences, often with one or more prior degrees, professions, or careers. The "typical" student in BSN programs is much younger, in his or her 20s, of the more "traditional" college mold.

I also was a "non-traditional" student myself when I started taking courses towards my ADN back in 1993. I was 38 years old, married, with two preteen children. I had some college background, but no degree. I also brought with me the seasoned maturity and perspective that only life experiences can bring.

All in all, it took me three years to complete the ADN program - one year to knock out all the co-reqs, and then two years to complete the rest of the program. Since I made very high scores on the entrance exam and all A's in the co-reqs (especially anatomy), I got into the competitive program on the first try. This was a program that rejected 9 out of 10 applicants (about 400 applicants for 36 slots).

For those with baccalaureate degrees in another field, the accelerated BSN or direct-entry MSN programs might be something to consider. At least in these programs, the student receives academic recognition (in that he or she receives a BSN or MSN upon graduation) for all those prior courses or degrees.

VickyRN, MSN, DNP, RN

49 Articles; 5,349 Posts

Specializes in Gerontological, cardiac, med-surg, peds.
AznMurse said:
considering all the credits, hours, etc. spent on the ADN program which most think should be more than an ADN to which I agree, Maybe they should rename the current ADN programs as accelerated BSN and totally eliminate the 12-15 months accelerated BSN program w/c to me sounds really absurd! How can someone learn all that much and retain it in just 15 months? Granted they pass the NCLEX but that could just very well be test taking skill variable.

I'll discuss the educational differences in BSN or accelerated BSN programs versus ADN in my next blog. There are some real differences in required curriculum. Please stay tuned.

VickyRN, MSN, DNP, RN

49 Articles; 5,349 Posts

Specializes in Gerontological, cardiac, med-surg, peds.
MedSurg32RN said:
Unfortunately, it is even harder to get into a BSN program. Both BSN and ASN could benefit from more clinical time. With many asking Congress to import foreign educated nurses the ADN is a good solution to nursing shortages.

This depends on your location. In my state (North Carolina), it is often easier to get into state university BSN programs than the typical ADN community college program. This is because the university BSN programs have extremely large class enrollments and admit in both the fall and Spring of every year. However both types of programs are very competitive and many qualfied applicants are turned away. And, with the BSN, the student must put in two full years for the prereqs before applying for the nursing program.

As for required clinical time, this is determined by state boards of nursing and not by individual nursing programs. Many BSN programs, however, offer an optional student extern opportunity over the Summer between the junior and senior years. This is 10 or 11 solid weeks packed full of intense clinical bedside experience.

VickyRN, MSN, DNP, RN

49 Articles; 5,349 Posts

Specializes in Gerontological, cardiac, med-surg, peds.
multicollinearity said:
I've seen ADN programs exceeding 85 credits. I think it's obscene for the degree-level being earned. I don't know how NLN lets their accredited programs get away with it.

This was the way it was in North Carolina, back in 1993. However, the Board of Nursing put a stop to this practice and ADN programs statewide had to be pared down to ~ 74 semester hours. Before the BON intervened, there were more co-reqs such as Microbiology and programs ran 80+ hours for completion.

VickyRN, MSN, DNP, RN

49 Articles; 5,349 Posts

Specializes in Gerontological, cardiac, med-surg, peds.
Jubilayhee said:
She mentioned North Carolina as having laws stating that ADN program must have the same clinical hours as BSN

programs. But I find it interesting that she doesn't mention the other states. Is it only like that there? I sense something amiss.

I suggest you contact your state BON to research this for yourself. Come armed with facts, not just opinions.

VickyRN, MSN, DNP, RN

49 Articles; 5,349 Posts

Specializes in Gerontological, cardiac, med-surg, peds.
wildchipmunk said:
Thank you for this excellent piece and the considerable effort you put into its creation.

You're very welcome. It's very interesting to me to research the development of all these divergent entry levels, their pros and cons, and to present the information in a non-biased manner.

VickyRN, MSN, DNP, RN

49 Articles; 5,349 Posts

Specializes in Gerontological, cardiac, med-surg, peds.
butterflydancer said:
Thanks for posting this! I look forward to reading your next segment

You're very welcome ?

VickyRN, MSN, DNP, RN

49 Articles; 5,349 Posts

Specializes in Gerontological, cardiac, med-surg, peds.
nursgirl said:
I am entering my last semester in an ADN program and overheard one of the nursing faculty say the other day " the ADN is the only 2 year degree that takes 5 years to get" hahahaha SO TRUE!!

It's well worth it though!! I will be done soon and able to work (God willing there's a job for me haha) and I can go on to acheive my BSN while I work... to this very poor college student this was the way to go... I will graduate with NO student loans to pay back!

On the downside... it will have taken me 5 years to complete my 2 year degree LOL ?

It will be well worth it in the end. Best wishes to you for a bright future in the wonderful career of nursing ? We may have many paths into our career, but the desire is the same - to provide the best patient care possible.