This article explores the pros and cons of registered nurses pursuing their BSN. The information included is based on the writer's personal observations and experiences, both before and after obtaining a BSN degree.
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If you're the kind of nurse who loves working three 12s and having the rest of your week off, you might find that options are limited away from the bedside. Many non-clinical positions are Monday-Friday, daytime operations that only offer 8 hour shifts. Some may offer 4-10s or rotating shifts, but 3-day work weeks are hard to come by outside of direct patient care.
If you really love taking care of patients, and really loathe sitting in meetings and doing paperwork, that's something to consider when thinking about your BSN. Leadership and education positions tend to involve a lot of writing and speaking; if figuring out schedules, sending emails, and giving presentations is not your thing, most administrative BSN roles won't be a good fit.
On the other hand, if the clinical aspect of nursing is your passion and you intend to eventually pursue an advanced practice role as a nurse practitioner or nurse anesthetist, you will absolutely need your BSN first. CRNA programs also require at least a year of recent critical care experience, so you won't want to stray far from the bedside once you have your BSN.
If you're thinking of getting a BSN just to earn more and become more marketable, it helps to have the facts. In many hospitals, there is no wage increase for earning your BSN. Most facilities determine pay based on the job description, more so than the credentials. For instance, the administration looks at market values and determines that RNs at the bedside should make X dollars an hour. Some may add a bit to the hourly wage for a BSN, but many do not; a bedside nurse is a bedside nurse and they are paid as such even with a BSN.
This is certainly something many would like to change, but before that can happen there will need to be a fundamental change in BSN education. Currently, a nurse can earn a BSN in a matter of months online without a single live lecture or any hands-on learning. Few, if any, BSN programs require a clinical component or practicum. There are no advanced clinical skills, no new knowledge significant enough to affect performance at the bedside, and therefore no real justification for an increase in pay. An overhaul to existing BSN programs, including advanced clinicals, might help to change that and make BSNs more marketable.
If you do intend to transition into a higher-paying leadership role with your BSN, go for it; just bear in mind that most management and education roles are salaried, not hourly, so figure that into your calculations. If you're someone who relies on occasional overtime or likes to pick up holidays for the premium pay, these differentials usually don't apply to salaried (aka "exempt") positions.
If you're trying to get ahead, continuing education and impressive credentials will certainly help. Bear in mind, though, that the BSN is becoming very commonplace now among bedside nurses. Many hospitals strongly encourage, and even require, nurses to obtain a BSN within a certain number of years after hire or in order to apply for transfers within the organization. In the recent past, BSN nurses were in leadership roles as nurse managers, directors of nursing in long-term care, and nursing instructors in diploma and ADN schools. Now that the average bedside nurse has, or is expected to earn their BSN, leadership and advanced roles are requiring even higher levels of education. You should absolutely pursue the degree if you want to advance, but many nurses now are also seeking additional certifications in various specialties like diabetes, oncology, or wound care, in order to stay competitive.
One more thing any nurse should consider before returning to school is the matter of finances. Some may qualify for federal grants or full scholarships, but most working nurses will end up paying at least part of their tuition and fees out of pocket. If you're lucky enough to get a free ride, take full advantage of it. If you're like most nurses and have to rely on student loans and/or tuition reimbursement, take all the factors into account before you decide. For instance:
What is your current financial situation? Even with student loans and tuition reimbursement, many nurses often have out of pocket expenses for every semester. If your nursing job lands you a certain income bracket, you may only receive partial student loans and have to pay the remainder of tuition yourself. That's something to consider if money is already tight. Also remember that currently, getting your BSN does not guarantee an increase in monthly income. All too often BSNs find themselves in the same job making the same money, but now with a student loan payment to contend with every month.
How close are you to retirement? The repayment period for most student loans is 10 years, so it may not be worth it if you plan to retire in 6. However, if your finances are such that you could pay extra or pay the loan off early, you might want to go ahead.
Are you planning to relocate or change employers after graduation? Employer tuition reimbursement usually exchanges financial aid for months or years of continued service post-graduation. If you leave your employment before the debt is worked off, the benefit has to be paid back to the facility. Read the tuition assistance policies carefully to determine how long you'll need to stay on after graduation and what your payback amount would be should you choose to leave early.
Is your projected BSN salary enough to balance out the student loan debt? Most BSNs end up paying around $240 per month for their student loan after graduation, so bear in mind that you'll need to make at least that much more per month just to break even. The sad truth is that as it stands now, many BSNs find themselves struggling to make that monthly payment when there is no wage increase for earning the extra degree. Leadership roles will usually pay you a bit more, but remember to think about the schedule requirements and exempt/non-exempt status of those positions.
Generally speaking, you almost can't go wrong with more education. The more letters behind your name, the better your resume looks, and there is also a sense of personal achievement. Still, when considering a BSN program, it's important to examine all the pieces: your goals, your finances, your lifestyle and family situations, as well as your likes and dislikes when it comes to work. Do you need to be home with your kids more? Do you rely on overtime or shift differential to make ends meet? Do you love patients but hate paperwork? These are all things to consider.
We all eagerly look forward to the day when the BSN translates to tangible benefits for the average nurse. Sadly, as it stands right now, for many there is no life-changing advantage and the BSN serves only as a stepping stone to an even higher degree or advanced clinical practice. The information here is not meant to discourage anyone from pursuing higher education, only to help put the undergraduate degree and its pros and cons into perspective.
If your facility requires the BSN for bedside nurses, then your choice is simple. However, if you just really love taking care of patients and have no desire to enter leadership or administration, you may fare better with a specialty certification in an area that interests you. The cost is far less, and the BSN does not focus on clinical skills. If you do want to qualify for entry-level leadership and education roles, then the BSN is the way to go. In future we hope to see the BSN carry more weight and offer more leverage, but to do so it must also provide increased skills and greater knowledge. Changes in education are likely the only thing that will translate into changes in benefits. Still, the great thing about nursing is that we have a wide-open, versatile field where there is something for everybody. Hopefully the information included here can help you decide which of those somethings is right for you in your own nursing practice.
I have noticed on this forum a decent amount of RN to BSN nurses disparaging the BSN - discouraging those who have yet to attain it. It's wrong. If the time comes that ADNs won't be hired or will be forced to get the BSN, those who already did it for themselves will be in the clear - remember that. By the way, there are MSN-prepared RNs...
I think that it is a tough call. Nursing historically has been a pink collar profession. It is a very physical profession, as we all know. We often judge each others' ability based on time spent at the bedside or ... how well you give report. There are people who LOVE this work and should continue doing it. I would continue working as an RN(bedside) for the rest of my life, because I love my patients.
For many, the commitment of continued education must have an immediate, usually monetary, incentive. The advantage of advanced degrees that I feel like a lot of people miss is the increased career flexibility. The more education you have, the more you can do and the more time you can have at home because you may be earning the same amount of money for less work hours, for example. By the way, I guess it depends on your organization but for every degree/certification/alphabet behind your name, there is a differential - typically an extra 100-1500 per year per achievement. There are certainly salary increases(many want magnet designation, so they will pay.).
As you can sense, I am a strong advocate for continued education and I strongly believe that we don't know what we are missing until we attain it. As soon as I started my DNP coursework, I immediately recognized the value that the degree brings to the table. I generally recognize the value and flexibility of gaining higher education - not just for me, but for the populations I hope to serve. It is an investment worth making.
The problem I see here is that some ADNs are complacent with their minimal entry level education. They cannot see beyond their task oriented roles. instead of striving to be "good", they're settling for "good enough". Now hospitals are saying the ADN degree isn't good enough anymore. ADNs need to understand that their experience will serve them well in a BSN program. The information isn't foreign to them. It just takes a little discipline to get through it. If your hospital is one that will pay or reimburse, take advantage of it. I waited too late and ended up paying for my school out of pocket.
If anyone has been listening there has been a few years of stress on the topic of evidence based nursing. That means you question how and why you to things, going back to theories and scientific inquiry. Yes it works. Ever question the why of doing things? Ever wanted to know if what you are doing for a patient really works or is just a bit of hockum? Go to the research or do your own, Nursing should not be a "well I guess" profession. It should be based in the realtime collection of data and results, called evidence. Does that mean that sometimes there still be some one who falls outside that norm, oh yes. I am not saying we should blindly follow the research but that we should not blindly follow our guts either. We should work towards incorporating practices that have some data to back them up. We quit doing shave-preps for surgery a long time ago. It was once the accepted practice and no one would go to surgery with out it being done. Until the data showed that an increased infection rate and other problems were a result of the practice(think evidence). The BSN should be the path to exploring the past present and future of Nursing practice regardless of what you do as a Nurse. It opens up the world of teaching others to do the same, teaching yourself not to just go with the status quo but to think outside your box, look for the opportunity, the key that brings the patient the best possible results. We do not necessarily cure, but we sure help patients adapt and learn how to beat the bad odds. We do that with an intelligent, thoughtful, compassionate approach to helping them find what works(regardless of how crazy it might be) based on knowledge, evidence and hard work. If your BSN program does not do that, whether you are doing an on-line or realtime program, you are in the wrong program. I graduated with my BSN in 1972 and that is the way we practiced then and the way I do it now. I want the data, I want the research and the experience of others to look at how things should be done. I don't take anyone's word for it, I do not fall into doing things that are "fads". It also does not mean you cannot be creative and have a good time with the profession and patients. I saw a quote once from a patient at Duke University Hospital. I cannot be exact but the gist of it was "please give me a nurse who can think, I do not need some one who cannot think caring for me." You all who are working towards the BSN keep going. The rest who do not see the need for the BSN, put your self in the bed and ask what kind of a nurse do you want when no one else can figure out what is going on with you? I will go with the nurse that can think. Thanks, hope this does not sound like a rant. For interest sake, I have a BA in English and Theology, a BSN and a Masters, I did 12 years in the Navy. I work direct care, shift work, love the patients and the families, bring it on.
nurseyblues said:As my article states, there is no way around the BSN if you're headed for grad school or if you want leadership roles. As you stated, the BSN also opens some doors away from direct patient care--and I think that is the biggest sticking point for me. For those wanting to get out of direct patient care or pursue higher degrees, the BSN is necessary and a worthy investment. However, for those nurses who intend to stay in direct patient care with no desire to leave the bedside or enter advanced practice, I'm not sure it makes sense for the profession to push them into earning an extra degree that they really don't need.
Whether it makes sense or not, if the BSN is required by the job market to get or keep a job, I'll be getting one. For now the thought is on pause, though. I'm wondering when the frappe I'll have the time, money, and energy for it while working full-time and trying to balance my life via non-nursing activities.
smartnurse1982 said:it is a sad truth, but you are correct. ADNs won't go away, just as LVNs/LPNs didn't go away, but they are scarce in Acute care facilities. The accreditation agencies are raising the bar for entry level for RNs. When it doesn't cost any more to hire a BSN than it does an ADN, then the answer is simple. Physicians have a minimum of 8 years of school, pharmacists have about 6 years, physical therapists have 6-8 years, and none of them spend as much time with patients as nurses do. It would make sense that nurses have a minimum of 4 years to work in a hospital setting.
It it was a great ride. My 2 year degree served me very well. I would estimate that over my 20 year career, I have earned around $1.5million, before taxes. I couldn't believe how good I had it. Times are changing, so I had to change. The nursing profession is like being a shark. If we don't keep learning (swimming) we will drown and get left behind. If we want to maintain our jobs, we must meet THEIR requirements. Most hospitals offer some form of tuition support which is more than fair. It isn't their responsibility to pay for our education needed to keep our job. Physicians cannot practice without their degrees and hospitals don't pay back the doctor's student loans.
It is what it is, either get on board or get left behind.
Neither physicians nor physical therapists would work for a typical RN salary or do the in-the-trenches work we do, and I can count on 0 fingers the number of doctors that have helped me clean up a soiled patient (the PTs have generally been much more team-spirited). I believe that much of the protest is that it MAY benefit healthcare systems (hospitals and patients) but often obtaining a BSN does not benefit the actual nurse.
My ASN program was accredited, it had competitive admissions and stellar NCLEX pass rates. Graduates of my program are desired within the community; I have never had a problem finding work. As an ASN-RN I have worked for 3 of the 4 major hospital systems in my city (not so many out of preference: left one due to not wanting to go down with the ship when the my satellite hospital closed, left one due to landing on what was labeled a medical rehab unit but staffed by rehab nurses without medical experience despite having very sick patients - left d/t safety issues, and the third I am still working for).
I would hardly say I am not wanted in acute care.
However, I recognize that the wind is changing. All these systems that have been happy to hire me have had a clause that hires must complete the BSN within 5 years of starting work. I'll get a BSN because I believe that my grace period will run out, and don't want to find myself non-competitive for the simple reason of the letters after my name.
smartnurse1982 said:Why are these articles coming out at a time I am deciding whether to quit WGU's Rn to Bsn program?I do not plan to be in leadership,will likely stay working PDN,certainly won't get a raise,so why am I pursuing a Bsn?
The most important point the author made is staying employed.
Let's say by 2030 80% of nurses have Bsn Degrees.
What happens to the Lpn's and ADN Rn's that do not have one?
Smartnurse makes the best argument for the degree and the argument I listened to when I decided to pursue the BSN at the start of my career. Through the years, I've seen absolutely no qualitative practice differences in my nursing workplace experiences, but I do know that the BSN greases the employment wheels. It did then, and it does now.
I think the BSN should be for everyone. But I also think it should be widely available and the current community college programs should somehow convert/matriculate simultaneously into BSN programs, eliminating the ADN level of degree entry into RN nursing. I am an ADN graduate, originally, so I am not downing them. But I think time has come, well actually, has passed, whereby the entry for all RN nursing should/must be the BSN.
SmilingBluEyes said:I think the BSN should be for everyone. But I also think it should be widely available and the current community college programs should somehow convert/matriculate simultaneously into BSN programs, eliminating the ADN level of degree entry into RN nursing. I am an ADN graduate, originally, so I am not downing them. But I think time has come, well actually, has passed, whereby the entry for all RN nursing should/must be the BSN.
The only way BSN will universally become the entry level is if the ANA and the BRN agree and change licensure requirements. The AD is the quickest and cheapest path to an RN license. the BRN should place limits on the ADN license and if the nurse isn't enrolled in a BSN program by the end of 5 years after their initial license, then it is placed on hold until the degree is completed. At least this will slow the ADN growth rate.
PearsonBSN said:The only way BSN will universally become the entry level is if the ANA and the BRN agree and change licensure requirements.
A common misconception. The ANA has no statutory or regulatory authority whatsoever, nothing to do with licensure, and the BONs are limited to implementing the standards and requirements written and passed by the state legislatures. The only way a change in requirements for entry to practice will ever happen is if the state legislatures are convinced that a BSN is necessary for practice. So far, that hasn't happened. Only one state, North Dakota, has ever passed legislation requiring a BSN for licensure, and the legislature rescinded the legislation several years later because it wasn't working -- they couldn't get enough nurses. Maybe, now that there are so many more BSN-prepared RNs across the country, that experience would be different; but the fact remains that no state is currently considering requiring a BSN for licensure. I've seen a few states (NJ? NY? I don't recall at the moment) talk about passing legislation that would require RNs to complete a BSN within ten years to be able to continue renewing their licenses, but I don't believe that even those proposals have actually been passed by a state legislature, and I haven't heard any news/updates about those proposals in a long time.
As a second career ADN, RN, I considered continuing my education to get my BSN upon graduation 5 years ago, but aging parents with severe disabilities needing assistance kept me from making that a priority. As time wore on, I decided that at my age, it wasn't worth the money, time, and stress; knowing that a BSN would not increase my income. However, after 5 years of working a busy surgical floor, I made the mistake of changing hospitals (after my former employer increased our RN to patient ratio). My new employer (a Magnet Hospital), failed to tell me (in the "you're hired" phone call) that I was required to start my BSN education within one year of employment (a brand new requirement). I discovered this 12 days after I gave my 2 week notice to a fairly new manager who was angry under which the circumstances I was leaving.
I knew that a Magnet Hospital would primarily hire BSN nurses but had also heard that they would hire ADN nurses with experience and none of my friends who worked there knew anything about this brand new requirement. So... here I am at 58 yrs old, needing to start school again or look for another job. I'm trying to view this "kick in the pants" as a blessing to open new doors for me in the future. But if I go through with this, I won't stop at BSN, I'll shoot for the MSN to make it worth my while.
Anyway, I hope that my shared experience will alert anyone without a BSN to investigate thoroughly before changing jobs!!
BostonFNP, APRN
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Perhaps those that don't seek out clinical leadership and research in practice alone explains the difference in outcomes found in the studies.