If we make BSN the entry level degree, we should be paid more

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First, I do not want to challenge nurses with several years of clinical experience that are ADN or diploma trained nurses or those nurses that graduated recently with a ADN, and I do not want to challenge anyone by saying that there is a difference between the ADN versus the BSN prepared nurse.

There is a push for all nurses to be BSN prepared or for ADNs to achieve their BSN; however, there is no increase in wages for the majority of those with their BSN or those going from an ADN to a BSN. I find that as a workforce, we do not understand our worth. Why do we need the BSN as it costs more and it has no pay benefits. Students that have an ADN from a community college have less student loans, and they make the same a student that has a BSN; however, the BSN student has increased student debt with no increased monetary income to show for their degree.

I challenge the nursing workforce to acknowledge our value as a profession, and demand an increase in pay if we are to have a BSN. The current yearly income of a nurse is based on the costs of an ADN level of education; however, it does not match the cost of a BSN cost of education. If I am required or it is preferred that I have my BSN, I need to be paid accordingly. I do not practice nursing strictly for the income, but I do appreciate putting a dollar value on the work I do.

Thoughts?

Specializes in Adult Internal Medicine.

The last study I know of that directly commented on wage differentials for BSN reported that 19% of nurses in hospitals reported a wage differential for BSN.

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
You may laugh at the advancement of education for nurses in the future but I still believe the BSN is possible as the entry.

Couple things. First, who is laughing? My "LOL" was only in reply to a silly comment you made, not about the subject. Second we are NOT discussing advancing nursing education. Merely having BSN behind one's name does not indicate an advanced education. Third, of course BSN will become the standard entry point for RNs.

Are you working in NZ now?

Not at the moment, but I maintain my license.

Working in another country is on my bucket list. But, some of us have already been to other countries through the military and do have some idea of their medical systems.

Ya, me too. 5 years active army. I deployed to a fair number of other countries. In addition when I graduated from high school I spent 18 months traveling around the world with a back pack. I worked and lived in several European countries. I had a job on a pig farm in Sweden, in a saw mill in Germany, a dairy farm in France. In between I back packed all over the place. Before that I spent 3 months working on a large cattle ranch in Argentina. After Europe I worked at a crematorium just south of New Deli India. Later I worked as crewman on several sail boats and larger boats too. Ended up working in a bakery outside Melbourne. Later on a 240,000 acre sheep and cattle ranch in central Queensland. Was a beach bum in Fiji for a few weeks. Due to the nature of the jobs I had I got the opportunity to be a patient in several places.

I base my opinion on the many nursing journals and personal experience.

Great! Please provide the journals where I may read about US nursing lagging behind other countries.

There are many published comparisons for nursing in different countries.

http://www.gken.org/Docs/Workforce/Nursing Educ Reqs_FINAL 102609.pdf

The paper you linked to does not support your claims.

Other than listing some countries who require a BSN this paper does nothing to support the claims you have made here.

It is also very difficult to make the comparison in "years" due to the difference in the educational system. It is a known fact that the US does lag in this area as a whole. Most European, Canadian, UK and Australian countries are doing what we consider "community college" studies while in their equivalent of high school.

Ya I know. I actually know more about the education systems in certain other countries than I do about the American one. Now that my kids are attending an American school I am learning a lot about the school system I never had the chance to learn before.

I have also been fortunate to work with NP who have at least a Masters and DNP from universities. I can not believe they would be granted a license with such responsibility after only an ADN and a rather quick NP course from what seems to be private colleges.

Private, except for all the public universities that offer RN to MSN. As I mentioned I only posted a few examples, not a comprehensive list. There are many, many more. You misread the programs if you think they are quick. They are the exact same NP programs nurses with BSNs take. Exact same length.

I suppose learning there are associates degree PA programs would really blow your mind?

I guess I will have to lower my opinion or expectations of NPs now since I see entry is relatively easy. I will be more diligent in double checking with a doctor on the orders written by them. Thank you for enlightening me.

LOL! Are you for real?

From your many posts I get it that you are not pro BSN and probably because you don't want to go back to school.

Uh, no. I already have a BSN. What I am is pro high quality nursing education and a very diverse nursing work force.

I find our current nursing education, including at the BSN and DE MSN level to be a joke.

But that does not mean education or the BSN is bad.

You are right to consider them separately. They really are two different things.

Look at all the other professions which have raised their standards. It would be very naïve to say you have not noticed this or taken note of the fact that CMS loves education.

Of course I have noticed. What I have NOT noticed is an increase in compensation or scope of practice for those professions. I also noticed that nursing alone seems determined NOT to follow the well trod path taken by pharmacy, PT and others, that is declaring a date after which the new standard is required for licensure and grandfathering in all those who became licensed under the old standard. Why do you think nursing alone refuses to take this established and successful path to a higher degree for licensure?

To me it is evidence that BSN as entry to practice is, at best, a secondary goal of the ANA and like minded people.

Take off the blinders. Medicine is advancing.

Your many attempts at personal insults aside, we have NOT been discussing advancing in medicine.

Change happens.

I welcome change that is appropriate and leads to better working conditions for nurses and better outcomes for our patients.

You can not keep living in the past assuming your ADN will always be adequate.

Wow, who is doing to assuming here?

I also take it to be true you have not worked in NZ to know what it is like and if your ADN is really equivalent.

I have worked in New Zealand as a critical care and A&C (ER) RN for several years.

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
Yes, they are by my employer. Rather significantly less.

Great! If a nurse is going to have to invest more of her time and money into obtaining a license they SHOULD be paid more. I think that is what this discussion is about. Provide a significant increase in pay for RNs who have degrees (not decreasing the pay of ADN and diploma RNs) and much of the opposition to requiring a BSN will evaporate.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
The last study I know of that directly commented on wage differentials for BSN reported that 19% of nurses in hospitals reported a wage differential for BSN.
All I have seen in the Boston area is $.50 to maybe $1.50 at a few select facilities....over all not much of a difference. I see more for CEN, CCRN.
Couple things. First, who is laughing? My "LOL" was only in reply to a silly comment you made, not about the subject. Second we are NOT discussing advancing nursing education. Merely having BSN behind one's name does not indicate an advanced education. Third, of course BSN will become the standard entry point for RNs.

What is your definition of education? A university can not do it all but can give one the resources for a good start. Some of the responsibility has to fall to the individual. What exactly are you looking for?

Great! Please provide the journals where I may read about US nursing lagging behind other countries.

The paper you linked to does not support your claims.

Other than listing some countries who require a BSN this paper does nothing to support the claims you have made here.

The US does NOT require a BSN. I provided you references for the educational levels for nurses in other countries. Couple that with the US educational system for students and you should have a good picture. You didn't believe other countries required higher education. I provided you with the sources which stated they did. What exactly are you looking for?

Uh, no. I already have a BSN.

You are right to consider them separately. They really are two different things.

Your posts are also over the place. The discussion at one point was about ADNs and other countries to which you said you got a NZ license. You made it sound like an ADN is no barrier to getting a license in another country. Of course it is much easier to get a license in another country if you meet the requirements and if there is a need. I don't know what country you are a citizen in either or even where you got your education or how you got a work visa for another country. At one point you said you didn't work in NZ and then you post about being there for many years working in ICU.

Of course I have noticed. What I have NOT noticed is an increase in compensation or scope of practice for those professions. I also noticed that nursing alone seems determined NOT to follow the well trod path taken by pharmacy, PT and others, that is declaring a date after which the new standard is required for licensure and grandfathering in all those who became licensed under the old standard. Why do you think nursing alone refuses to take this established and successful path to a higher degree for licensure?

To me it is evidence that BSN as entry to practice is, at best, a secondary goal of the ANA and like minded people.

Unions and employers also must cater to the lowest denominator. Before standards/scope/wages can be raised more people have to be at the higher level of education which the easiest way to demonstrate that is through a BSN. The surveys are out there indicating job satisfaction is higher in Magnet hospitals or hospitals which promote the BSN for entry into a job. But, because some ADNs don't want change, many hospitals and unions (which control wages) will cater to the ADN and probably use the same arguments you have that a "BSN" is not education and means nothing.

Your many attempts at personal insults aside, we have NOT been discussing advancing in medicine.

Where have you been for the past 20 years? How can you not say medicine is not advancing? Ever hear of Evidence Based Medicine? Nursing directed protocols? Have you seen all the new medications, treatments and technology?

I welcome change that is appropriate and leads to better working conditions for nurses and better outcomes for our patients.

You have failed to read or make yourself familiar in any way with what is happening in nursing. You have a strong opinion against the BSN even though you say you hold the degree. You are probably the most negative person whose posts I have read to hold back the BSNs from increasing in pay and scope at some hospitals. As long as you and others like you keep bashing the BSN degree, nothing will change where you are. I guess you believe the degree you have has failed you but like I stated before, some of the responsibility also falls to the individual. If the BSN degree has failed you, I believe you have no one to blame but yourself and your attitude.

All I have seen in the Boston area is $.50 to maybe $1.50 at a few select facilities....over all not much of a difference. I see more for CEN, CCRN.

This can be deceiving for pay since Magnet level hospitals are trying to restructure their pay scales. There also fewer ADNs at some steps and units so you won't notice a differential since the pay has already been adjusted to reflect the BSN. In hospitals with a large number of ADNs, unions and employers will tend to cater to the lowest denominator. For the union it keeps the majority in that hospital happy and for the hospital it may save money by paying for the lessor education level if BSNs are the minority. There may be enough ADNs to keep the BSNs quiet and set the pace for the hospital.

Eventually we will see more salary surveys for the Magnet vs non Magnet hospitals. Those will be more interesting.

Great! If a nurse is going to have to invest more of her time and money into obtaining a license they SHOULD be paid more. I think that is what this discussion is about. Provide a significant increase in pay for RNs who have degrees (not decreasing the pay of ADN and diploma RNs) and much of the opposition to requiring a BSN will evaporate.

Did you know that the teachers educating your kids in the US school system need at least a Bachelors and most have a Masters just to teach elementary school but are paid half of what RNs make in some parts of the country? What is your stance on that? Should teachers only be required to have a 1 year certificate which would be more agreeable with their pay?

Specializes in Critical Care.
What are you talking about?

Maybe we've lost track at this point, but the statement I still don't understand is this one: "Surely in all of your college experience you have heard this reference made by all of those irresponsible spoiled little brats with no work ethic. This is even discussed among juniors and seniors in high school as they make out their college applications."

Do you not understand the difference between semester and quarter units? The UCLA system is quarter as I pointe out. At minimum some colleges have 160 units but UCLA just happens to have 180 required. This is not semester units. You need to understand the difference which I clearly stated earlier. I have no idea what you are trying to prove with this. Just do a little math for the conversion between units.

I'm well aware that UCLA is on a quarter system, the comparison I gave was also using a quarter system, I haven't referenced a semester system at any point so I'm not sure what you're thinking I failed to convert.

I think you missed the prerequisite or lower class credits.

Nope, I noticed them. Are you under the impression ADN programs don't have prerequisites?

Here is an example of an ADN program.

SDCity > Academic Programs > Programs of Instruction > Nursing Education > Registered Nurse (RN)

Again, it might help if you posted links to the ADN programs you are talking about.

I tend to buy into the idea that you don't give away your home location on a public forum, but I'll try to find examples from elsewhere.

I got the part about them being the same from you and I have been arguing with examples that they are not. I also post what an articulation program is.

I'm pretty sure I specifically said they aren't as different as they used to be, where to did you get that I said they are the same? There are still differences, the question is how much value there is in those differences.

Are you saying your employer actively discriminates against those with a BSN? Is this because they are cheaper? Or, is it because the managers are the ones who lag in education and have not advanced their education level? Either way it does not speak well of your facility to put a hold on education.

They put a hold on BSN's due to increased orientation/clinical training costs.

I can now see your bias since your employer is a CC. I would hope your college has educators who hold at least a BSN.

I would hope anyone discussing ADN and BSN education would be aware that a masters degree is required for classroom education at both the ADN and BSN level. I don't work for a CC, I volunteer on an advisory board for a program with four lecture staff; 2 masters and 2 doctorate.

In your preadmission session do you explain about the advancing standards and that many employers now want a BSN? Or, do you paint a very rosy ADN picture and that it will be THE degree forever and nothing will every change? Not all hospitals will be hiring just ADNs like your employer.

They provide current survey results for various regional employers including degree preference, placement statistics and in what type of setting, as well as nation-wide numbers.

I'm saying ADN is THE degree? Maybe I'm not explaining it well, but what I'm saying is that BSN is not necessarily THE degree, we need to consider what it means to Nursing and the effects on our future.

Specializes in Critical Care.
Did you know that the teachers educating your kids in the US school system need at least a Bachelors and most have a Masters just to teach elementary school but are paid half of what RNs make in some parts of the country? What is your stance on that? Should teachers only be required to have a 1 year certificate which would be more agreeable with their pay?

That's an excellent example of our misconceptions that we don't seem to think is possible. Teachers, in part believing they could gain respect and pay by adding a masters or masters equivalent requirement, increased their educational level beyond even the post-bac requirements that existed in many places, how did that work out for them?

Specializes in Critical Care.
You may laugh at the advancement of education for nurses in the future but I still believe the BSN is possible as the entry.

How is that possible? Would a BSN still be the same with half the clinical experience?

Specializes in OR, Nursing Professional Development.

There is a differential for BSN at my facility, but it's not across the board or called that. Basically, the only way to reach the top of the clinical ladder is to hold either a BSN or certification. So, while all BSN nurses are "eligible" for a $2/hr differential, the work required by the hospital to reach that level is insanely difficult.

I do think that we need a uniform entry to practice, but those already in school or working need to be grandfathered in. So many other professions are upping the requirements, yet nursing has been trying to establish a uniform entry to practice for decades.

That's an excellent example of our misconceptions that we don't seem to think is possible. Teachers, in part believing they could gain respect and pay by adding a masters or masters equivalent requirement, increased their educational level beyond even the post-bac requirements that existed in many places, how did that work out for them?

What do you believe the education level for teachers should be? A 6 month certificate? Did you know that the salaries of teachers depend on tax base and public funding through tax amendments? I bet you voted "NO" on any amendment to support education in your area.

How is that possible? Would a BSN still be the same with half the clinical experience?

Why are you suggesting that the BSN offer only half the clinical experience? That is a ridiculous suggestion. BSN programs do not decrease clinical experience. Some even offer more hours and the BSN also gives the opportunity for externships and residencies which some are only available to BSN grads. Please provide links that BSN programs are cutting their clinical hours in half.

I'm well aware that UCLA is on a quarter system, the comparison I gave was also using a quarter system, I haven't referenced a semester system at any point so I'm not sure what you're thinking I failed to convert.

The 120 hours which you previously stated is the credit hours for a BSN using the semester system, not quarter. This is all very easy to look up and it would be to your benefit if you are on any "committee".

You say you are on committees for ADNs to articulate into a BSN program. Yet, you show NO support for BSNs. You present the BSN grads as needing more orientation than ADN because you claim they do not have clinical experience. You really seem to have a problem with BSN grads which sounds more personal than factual. I will tell you the same as I told PMFB. If you believe the BSN degree has failed you, maybe you should take into account that your own attitude is largely to blame.

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