Is the BSN for Everybody? Things to Consider when Considering School

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. Nurses Announcements Archive Article

  1. Does the BSN really benefit bedside nurses?

    • 17
      No. The job is the same with or without the degree.
    • 32
      Yes. The BSN improves direct bedside care.
    • 26
      Yes, but only as a stepping stone to advanced clinical practice (FNP, CRNA, CNS)

75 members have participated

How important is schedule to you?

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.

What part of nursing do you enjoy?

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.

Is your goal to get a raise?

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.

Are you hoping for a competitive edge in the job market?

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.

Is money no object?

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.

What's the bottom line?

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.

Specializes in ER/Trauma, IV Therapy, and nursing management..
AJJKRN said:
"Would it not be better to leave the BSN for those who do want to enter leadership, nurse education, or graduate studies, and let the bedside nurses who really love patient care to focus on that?"

With all of your research on this topic, why oh why did you not notice that the MSN is the new BSN...:yawn:

I did notice, which is one of the points I attempt to make. That with every nurse on the floor having a BSN, now nurses need to have an MSN to be competitive or apply for higher-paying jobs. That means that those currently holding an MSN would need to pursue a doctorate to advance, or even remain competitive. All of this leads to each of these groups incurring student debt and expecting/requiring higher pay to offset that expense, and at a time when CMS and private insurance are continually finding new and interesting ways to reduce and even deny reimbursement for services.

The fact is that the MSN is the new BSN, and the BSN is the new RN, but my question is whether that is really necessary for bedside nurses to continue performing the direct patient care they've been doing all along?

Specializes in geriatrics.

Having a BSN provides options. While you may be employable now, more facilities will likely be moving towards the BSN requirement in the future.

The "nursing shortage" will likely never materialize as beds are closed and care transitions into the community. This is already happening, because many areas are cutting costs in an attempt to balance their budgets.

Many leadership roles require a BSN or higher. What happens when you want to move away from the bedside?

In addition, many countries require a BSN as entry to practice. I have read various posts over the years here regarding frustration from Americans who want to work in Canada or Australia, but there are additional requirements for those without a BSN.

It's not for everyone, but consider your options with or without the degree, and then decide.

Specializes in Nephrology, Cardiology, ER, ICU.

Great article - thanks for sharing.

Like TheCommuter, I did the LPN to ADN to BSN to MSN to post-MSN. I do not feel the BSN made me a better bedside nurse - it made me a poorer bedside nurse!

The degree that provided me with more options was the MSN.

I can't speak to inpatient nursing though there seems to be a consensus that bedside nursing is mostly task oriented.

In home health however, the common Case Mgr position is changing and requiring more leadership than ever to be effective in managing the increasing number of higher acuity patients coupled with complex psychosocial issues. It requires the nurse to literally direct all aspects of care, not simply perform assessment, teaching and procedures. It requires a strong understanding of regulatory and reimbursement criteria to manage the care within budget and maintain compliance while also meeting the objectives of the entire continuum of care.

I do not understand why there is a difference between our BSN and ADN nurses in their ability to understand and master these responsibilities as my BSN program sure didn't teach them. I don't know if it's personality or institution preparation but home health nursing today demands much more than simply straight forward tasks of our nurses, the tasks themselves while seemingly overwhelming to many of our new hires are really pretty basic in relation to the leadership responsibilities. And teaching leadership to those not inherently inclined is challenging.

Now I wonder if the mindset of inpatient nursing came more from a perspective of directing care, would the current climate change at all?

ETA We pay more for BSN and/or a nurse with significant and relevant experience. Our nurses' decisions have a direct impact on our revenue, it's much more than there being no difference how a foley is placed.

Specializes in ER/Trauma, IV Therapy, and nursing management..

I completely agree with Mom of 4 that we as a profession need consistency in our education and how we enter various points of the market. I respectfully disagree that the BSN should be the minimal starting point for all bedside nurses. I feel that requiring a 4-year degree just to get started may discourage some who are in need of stable employment now, and in my experience the BSN curriculum offers a lot of leadership and academic content that is more beneficial to roles away from direct patient care. Requiring the BSN just to get started would also devalue all the degree above the BSN. As another poster stated, the MSN is the new BSN, which means the PhD becomes the new MSN. Every higher degree becomes a step down from what it was. In that situation, when a PhD becomes equivalent to a Master's degree, where do you go from there? There is no higher degree to pursue, and pay will not keep pace with the education since the job itself is not changing—only the credentials are.

If I could set up my idea of consistent and practical nurse education, it would be structured something like this:

ADN: Entry point for bedside nursing.

These nurses are the bulk of the nursing workforce should come into the market as skilled clinicians ready to provide care to actual human beings. ADN programs would consist of the necessary basics like college math, A&P, and ethics, then the remainder of the curriculum would focus on intensive clinical training and practical exams. Making ADN the entry point ensures that every nurse has the credibility that comes with having an actual degree from an accredited school, and prevents the market from having to wait 4 years for new talent to enter the field.

Specialty Certificates:

I would like to see ADN schools also offer specialty certification programs for ADNs with at least 1 year of work experience. These programs would be short, clinical intensives in areas such as wound care, diabetes, telemetry, etc. and would require that the student pass a standardized certification exam. This would give new nurses a chance to advance their bedside practice, earn a bit more than the new ADN grads coming into the field, and act as mentors in the clinical setting. There would also be significant benefits to the patients and facilities as a result of having highly skilled, specially trained clinicians working on the patient care units.

BSN: Entry level administrative/non-clinical positions.

These would be the nurse unit managers, case workers, clinical coordinators, etc. BSN programs already focus on leadership and business, with minimal additional clinical training, so this degree is a good starting point for those wanting to branch away from the bedside. I would like to see BSN programs require 3 years of ADN experience prior to enrollment, with at least 1 full year being in an acute/inpatient setting.

MSN: The doorway to middle/upper management and administrative roles.

These would be the DON's, the nursing instructors for all the ADN/BSN programs, the nurse consultants, those who perform work in clinical trials/research, etc. This degree would require 3 years of actual nurse experience, with at least 2 in an inpatient setting. I believe that to lead others, a nurse needs to be at least as proficient, and preferably more, than those being led.

DNP: The standard for Advanced Practice Nursing.

Nurses working as Nurse Practitioners, Nurse Anesthetists, Nurse Midwives, and Clinical Nurse Specialists would hold this degree. DNP programs would again consist of intensive clinicals as well as the leadership and business curriculum that independent practitioners need to work safely and legally. These specialties function similarly to doctors, and should therefore also hold a doctorate degree for consistency, credibility, and national marketability. A minimum of 5 years actual nursing experience would be required, with at least 2 in the area of specialization (for instance, midwife students would spend at least 1 year in Labor & Delivery, etc.).

PhD: The upper echelon of nurse academics and leadership.

These would be the Chief Nurse Executives, Legal Nurses, Nursing Professors for MSN/DNP programs, and senior nurse researchers. These are the nurse theorists and scholars who write the textbooks, and the nurses who lobby for the profession in political arenas. An MSN with a strong GPA and solid work history would be required for enrollment in this highest-level program.

A structure like this would not only ensure consistency and lend credibility to each role, it would also justify a pay scale that reflects the amount of education and clinical experience for each tier. It would be easier to demand higher pay as a BSN, MSN, etc. if you were actually doing a different job that required different education and experience.

I think that some of these online programs are nothing more than a "racket". The amount of money charged is a rip off! Designed to make money knowing that many facilities are moving to hire BSN only

here in the Bay Area, you NEED your BSN to get a job if you have no experience. And if you aren't already an RN, you most certainly CANNOT earn your BSN online in a matter of months (i wish!!!). Those programs are only for folks who are already practicing RNs. When starting out, there are tons of clinical hours required and the programs are very serious. If you are already a working RN then this article applies to you, but if you don't have the RN license yet and are just starting out, then the BSN route may make a lot more sense if you are in an area that won't hire ADNs with no experience.

oh also, most of us trying to get our BSN only want to be bedside nurses working 3 12s or 4 8s. But around here you have to have a BSN for those jobs.

With the level of responsibility required to perform well, I respectively 100% disagree that entry level degree should remotely be decided on providing stable employment to those needing it now.

Specializes in ER/Trauma, IV Therapy, and nursing management..

Thank you, traumaRUs for your interest and comments. I worked my way up, too, and I was genuinely surprised at how little the BSN did for me as a clinical nurse--other than allowing me to enroll in the master's program that I expect to actually make a difference.

I really feel for those nurses who went back to school for their BSN only because they were compelled by the pursuit of Magnet status or requirements by their employer, only to find that they would be receiving no pay increase despite racking up thousands in debt. I think the BSN is fantastic for nurses looking to move away from bedside nursing, or those seeking to enter graduate programs. For those who just really love bedside nursing, are good at that vital role, I don't feel like it benefits anyone to force them to get a BSN that will not change the job they do, how they do it, or how much they're paid for it.

Specializes in Nursing Professional Development.
nurseyblues said:

If I could set up my idea of consistent and practical nurse education, it would be structured something like this:

I agree with some of your ideal structure ... but disagree on a few details.

I would keep the ADN as an acceptable entry-point -- but I would encourage the BSN as an entry-level as well. There is much to be gained from the "traditional 4-year college" experience and it should remain an option for those who want it. Without that option, the profession would lose a lot of talented people who want to "go to college" like people do in other professions.

I would limit the ADN role to the entry level roles -- not including charge functions, precepting, unit-level leadership, staff development, etc. Those types of things would be BSN level functions. BSN programs would focus on producing a well-rounded general nurse with coursework consistent with a liberal arts foundation -- some physical sciences, social sciences, and humanities -- so that graduates would be well-prepared to face all aspects of human existence. BSN programs would also include some electives so that individual students could focus of their favored interested in more depth.

Specialty certification exams would be offered at 3 levels -- the ADN, BSN, and graduate levels. That way, all nurses would have a way to show that they had specialized knowledge in their focus area -- appropriate for their level of education. Like now, the specialty exams would require at least 2 years of work experience in the field at the level being certified.

Specializes in ER/Trauma, IV Therapy, and nursing management..
Natalie513 said:
And if you aren't already an RN, you most certainly CANNOT earn your BSN online in a matter of months (i wish!!!). Those programs are only for folks who are already practicing RNs.

You are correct about that, and that is what I was referring to: working RNs who go back to earn the BSN. I apologize for not clarifying, and thank you for your comment. This article was written to those considering going back to school for a BSN.