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

Nurses Activism

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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 Critical Care.
Nurses do have a high level of responsibility. Curiously they don't have a high level of liability but that is another discussion.

Do school bus drivers hold children's lives in their hands daily? Do pilots and air traffic control techs hold hundreds of lives in their hands?

Air traffic controllers do have a high level of responsibility, although I'm missing your point if that means Nurses shouldn't expect to make more than air traffic controllers, they make $120,000 a year, without needing a bachelor's degree.

Specializes in Adult Internal Medicine.
So you're arguing Nurses are overpaid?

Not overpaid, there is not data that I have seen addressing overpay, so I wouldn't comment on that objectively. Subjectively I wish nurses made more, of course.

Objectively, nurses are well paid for entry to practice, at least on paper.

Sorry I did assume most actively debating this subject would have a general idea of the landmark studies on the topic.

I would be happy to provide studies for you to read. Would you like the most recent or the major landmark studies? US-based or international?

You really assumed that? A heck of an assumption.

These guys have a vested interest in pushing the issue, and did a pretty good summation

It seems to me that some of these studies take a bit of a leap. This study, For example, does not even account for nurse/pt ratios. And if you look at the breakdown, level of nursing degree actually plays a pretty small, role in pt outcomes. There are a number of other controllable variables that also affect outcomes.

While I question the self serving conclusions AACN makes from these studies, that really isn't relevant to the OP. The initial post was based on the assumption that since I paid more for my degree, I should get paid more. What you pay for something and what you can charge for it are independent of each other.

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
I worked hard for the 82k, I worked nights and weekends and holidays, I shouldered a great deal of responsibility.

*** I don't doubt that you worked hard for it. The graduates who work in the local teaching hospital work hard as well for only slightly more than $20 and hour. If they work in any of the smaller hospitals they can expect to start at $19-$22 and hour.

Cost of living aside, $20/hr seems brutally low. Most LTC new grads here start in the low to mid 30s. Perhaps I am biased by living in a high cost of living locale.

*** The cost of living here is obviously much lower. However newer nurses here don't expect to be able to support a family and purchase a modest house based on their income alone. It's the reason I commute a long way to work to make a lot more money.

As far as my comment about personal assaults, if the previous question about my experience as an RN was something non-personal, enlighten me

as to how it relates to the global issue at hand?

*** You expressed an opinion on nurses pay after being asked for it. I wanted to know if you had personal experience. In the age of DE APN programs it can't be assumes that an NP ever worked as a bedside nurse. In no way an assault on you in any way.

Specializes in LTC/Sub Acute Rehab.
This thread is interesting, and many have brought up good food for thought.

Does anyone have any knowledge of statistical studies of RN wages over the last twenty years (by state and/or region)?

One thing that I keep seeing on AN, are salaries that are often hovering around only three or so dollars more/hr. to what I made as a newish grad (ADN) 20 years ago. And that was in one of the lowest paying states in the nation (49th, to be exact, for nurse salaries). Of course, I'm only speaking in anecdotal terms here, based on general observations.

I'd be willing to bet that a person good with numbers could prove that that's not merely wage stagnation, it's regressive.

And now "they" want BSN's for similar dollars/hr. where those same dollars are worth far less than two decades ago? And just who the hell are "they" anyway? Educational institutions? (They do receive funding dollars to expand nursing programs).

Interestingly, community colleges now stand poised to implement BSN programs (of course, they're getting funding to implement these programs). Yes, a BSN at a community college. In my state, it's already happening.

We're being had.

I'm finishing my BSN as I type, but the cost may well be > benefit.

This is what I have never understood. We as a collective group of professionals no matter what title you possess behind your name, can never agree on what is an acceptable "entry-level" of practice. The major Nursing organizations , the REAL POWER PLAYERS, either refuse to, or just don't know how set the "standard;" if they did, we wouldn't be beating this dead horse who refuses to die. And further more, how can "they" be the "leaders" of our profession if they can't agree amongst themselves and have the nerve to attempt to "lead" and set "standard" for us? It's a fair question.

If entry into practice is going to be the BSN, JUST DO IT ALREADY! Force the local community and technical colleges to offer ONLY BSN programs along with the 4 year universities because it is THE SET STANDARD AND ANYTHING LESS WON'T RECOGNIZED (in terms of RN education); and then there will be nothing to "debate" about.

It's pure foolishness for ADN AND BSN prepared Nurses to argue amongst each other about who is the "most valuable" and how having a BSN Floor Nurse is better than having a ADN Floor Nurse and having "studies" to prove it. HOW WOULD THE PATIENT KNOW WHO HAD A BSN OR ADN if they weren't told? It's all about the care you deliver and how well you treat people while you're on duty. There are crappy LPN'S, ADN'S, BSN'S, AND MSN'S giving care to patient's all over the country; WE ALL KNOW ONE OR HAVE WORKED WITH ONE! And as far as money goes imo, ALL ENTRY LEVEL RN'S SHOULD BE PAID THE SAME. The more experience you have, the more you will be compensated for that experience. When you become a Manager or APRN, YOU WILL MAKE MORE MONEY! Nuff said!

Specializes in Adult Internal Medicine.
You really assumed that? A heck of an assumption.

These guys have a vested interest in pushing the issue, and did a pretty good summation

It seems to me that some of these studies take a bit of a leap. This study, For example, does not even account for nurse/pt ratios. And if you look at the breakdown, level of nursing degree actually plays a pretty small, role in pt outcomes. There are a number of other controllable variables that also affect outcomes.

While I question the self serving conclusions AACN makes from these studies, that really isn't relevant to the OP. The initial post was based on the assumption that since I paid more for my degree, I should get paid more. What you pay for something and what you can charge for it are independent of each other.

Again apologies for my err in assumption, I don't tend to assume any nurses are ignorant to the issue being discussed.

Since you mentioned nurse-patient ratios, we can start with the 2011 study that evaluated the three key concepts in nursing outcomes fro the extant literature: nurse-patient ratios, nursing education level, and work environment. Admittedly, this study suffers from the same design limitation that previous studies have in the use of linked rather than direct data on nursing characteristics, however, the study itself is well-powered enough that it is reasonable (in my opinion) to consider the design valid. I would always love to hear thoughts on the publication as the results are interesting.

As far as a "small role" in outcomes, I certainly agree there are many other important factors, though we differ in the sense that I tend to view effects at significant or not significant, regardless of "size".

Aiken, L. H., Cimiotti, J. P., Sloane, D. M., Smith, H. L., Flynn, L., & Neff, D. F. (2011). The effects of nurse staffing and nurse education on patient deaths in hospitals with different nurse work environments. Medical care, 49(12), 1047.

interesting comments. I remember working on a travel assignment at a nassau county hospital, I made a comment in the break room to one of the nurses, that I thought it was so cute that the little old lady volunteers came dressed like nurses. The next thing I knew the nurse was crying her eyes out saying that that would be her in a few years. Apparently the salary of the ses non-unionized nurses did not matter the degree was almost half of what nurses were making 30 miles away.After becoming unionized they went from 28 th. to 56 th. almost immediately, Most hospitals will give you an extra thousand on top of your yearly salary for each degree.

is that new grad as a RN or new grad as FNP?

Specializes in Geriatrics, Dialysis.
This thread is interesting, and many have brought up good food for thought.

Does anyone have any knowledge of statistical studies of RN wages over the last twenty years (by state and/or region)?

One thing that I keep seeing on AN, are salaries that are often hovering around only three or so dollars more/hr. to what I made as a newish grad (ADN) 20 years ago. And that was in one of the lowest paying states in the nation (49th, to be exact, for nurse salaries). Of course, I'm only speaking in anecdotal terms here, based on general observations.

I'd be willing to bet that a person good with numbers could prove that that's not merely wage stagnation, it's regressive.

And now "they" want BSN's for similar dollars/hr. where those same dollars are worth far less than two decades ago? And just who the hell are "they" anyway? Educational institutions? (They do receive funding dollars to expand nursing programs).

Interestingly, community colleges now stand poised to implement BSN programs (of course, they're getting funding to implement these programs). Yes, a BSN at a community college. In my state, it's already happening.

We're being had.

I'm finishing my BSN as I type, but the cost may well be > benefit.

Good points. Wage regression sounds right to me. I started working as a CNA in 1994, making roughly $7.00/hr and by 1999 still as a CNA I was making almost $12.00, compare that wage with the current wage for a CNA with 5 years experience which is still less than $12.00/hr.

I am seeing the same thing since becoming an RN, I started at a hair under $20.00/hr in 2002 and fast forward 10+ years and I am making a hair over $25.00/hr. Not really a wage increase at all considering COL is higher for everything; basic expenses are higher, my insurance rates are higher, my taxes are higher...taking this into consideration I actually make considerably less now than I did as a new grad RN 11 years almost 12 years ago.

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.

If entry into practice is going to be the BSN, JUST DO IT ALREADY! Force the local community and technical colleges to offer ONLY BSN programs along with the 4 year universities because it is THE SET STANDARD AND ANYTHING LESS WON'T RECOGNIZED (in terms of RN education); and then there will be nothing to "debate" about.

*** IMO this would be fairly easy to accomplish and the advocates of BSN only entry to practice would not have such a fight on their hands if they would simply follow the examples of the other health professions that have moves to a higher degree for entry. That is simply grandfather in all the diploma and ADN RNs and set a date after which only BSN prepared grads will be eligible to sit for the NCLEX RN.

However the ANA, AACN and the like minded refuse to do so. Instead they seem set of punishing all those who had the gall to enter practice with less than a BSN. They would rather yank the title "RN" away from those nurses and calling them "technical nurses", or just as bad kicking them out to the unemployment wasteland.

To me it demonstrates their true motivations.

Specializes in Peds/outpatient FP,derm,allergy/private duty.

Post for all of us here a link to the study you consider most relevant.

That's a great suggestion as any international studies would be worthless without factoring the actual content of their country's "BSN". Even the Canadian system has enough differences to make comparisons problematic.

Long as the message about a "nursing shortage" is still being shouted from the housetops, ADN programs are not going anywhere. End of story.

Those who run and or have vested interests in associate degree programs will point to they are the quickest way to produce "much needed" nurses. They will also point to the cost difference between themselves and a four year program.

On the political front there is not a state governor or legislature yet ready to take on the unions and or other powerful lobbies that run ADN programs. From community to private colleges you are going to have to work very hard to convince state lawmakers to essentially shut down vast numbers of schools and potentially creating hundreds of unemployed.

Now if a state moved to some sort of mandatory BSN for entry it would give some cover, but the same problems listed above would remain.

There is also at a time when states have been cutting back financial aid who is going to foot the bill for all those undergraduate students to attend four year (or longer) programs?

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