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.

  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.

nurseyblues: thank you so much for an excellent article and on-going commentary. I agree with the poster who said you were a good writer, and would very much appreciate seeing an equally thoughtful article on the merit of "for profit" vs "non profit" nursing education. I am personally concerned about the outrageous amounts of tuition these "for profit" schools charge. I personally know of too many young people lured more by the access to easy $$$$ (loans) than the long-term financial consequences of their decision. Finally, this is especially newsworthy, given that ITT is very much in the news these days. Keep writing-- you have a talent for it!

nurseyblues said:
Thank you so much for your warm comments and support. Because of my own (poor) experience with a for-profit school and my decision to transfer to a state school, I have been looking more into the for-profit vs. nonprofit issue in nursing education. I think this is a serious concern that impacts not only individual nurses, but the profession and healthcare itself. Thank you for the idea for a follow-up article!

I hope it's not the wrong place to share ideas for the article. If you watch the Frontline be sure to note the part about the telemarketers who call themselves advisors. I have personal experience that they can be hugely pushy and manipulative. I have blocked most of the phone numbers. I would be curious what sort of commissions they make and how they are trained. I suspect commissions are huge and that they know next to nothing about nursing except talking points where nurses feel vulnerable.

And yes, what is the financial deal between the hospital chains and the schools? Is there a kick back or incentive?

Nurses are by and large great people. I think that we are being exploited in this arena and it makes me furious.

Specializes in Surgical ICU, PACU, Educator.

The RN entry level has long been an area of contention. Over 90 years ago, The Rockefeller Foundation and the Goldmark report indicated the BSN needs to be the entry level. The Rockefeller Foundation and Annie Goodrich in 1923 designed the Yale School of Nursing BSN program as the best way to educate RNs. A big area of design was the Yale BSN program was 5 years long. The Yale program used a 3 year Diploma program with an additional 2 years of general education to gain a BSN

What we see now is a condensed four year, 8 term, version of the BSN with very little clinical experience. Creating BSN novice nurses with little clinical thinking ability. Does this change make the BSN for Everybody????

My question changes to: Is the BSN degree of value or is it the clinical experience of a ADN or Diploma Nurse ?

That brings me back to question Is the BSN for Everybody? Possibly not without clinical experience.

Maybe dissection of the question a little deeper. Is there more need to look at the ability to incorporate critical thinking concepts for the RN. Thinking ability should improve with the additional general education for BSN nurse. The next question. Do the current BSN programs really improve thinking ability???

My completion of the BSN and MSN makes it easy for me to say minimum entry level should be a BSN. My real feeling.... with additional time to develop thinking then a BSN is for Everybody.

I have a question if anyone knows the answer; I have a Bachelors in Business and a Masters in Business. Would I have to go for a BSN or can I just get an Associates RN?

There are plenty of reputable bachelor's-in-anything-to-BSN or -MN programs you could consider.Check out the MGH Institute of Health Sciences to get an idea of what a real program is.

Specializes in Crit Care; EOL; Pain/Symptom; Gero.
nurseyblues said:
Thank you for taking the time to read my article, and I can certainly understand and appreciate some skepticism. As this is my first formal submission, I was unsure of whether to include citations and references. I wrote this article based on my own experience of going into a BSN with so many expectations, and finding out the reality was quite different.

You have identified the flaw in this article - it's all opinion. Could have been titled "One Nurse's Opinion on the Need for BSN Education", or "One Nurse's Experience..."

In order to be taken seriously and to produce something useful for other nurses' consideration, next time, include evidence from current literature and data based on national trends.

That said, you write well.

Specializes in CRNA, Finally retired.
Sirena922 said:
I have a question if anyone knows the answer; I have a Bachelors in Business and a Masters in Business. Would I have to go for a BSN or can I just get an Associates RN?

Unless you wanted to be relegated to a less desired geographical area, this is a no brainer. Get the BSN. You have already invested heavily in education and an ADN can relegate you to a dead-end position you may not want as you get older. If you live in an area with a nursing shortage, you'll have a better chance of a desirable job without it. In larger cities and academic settings, BSN will be the bottom-line. Those business degrees will count for nothing in nursing (but despite what people may say on this forum, an education is NEVER wasted!). I bet you'll be great at presenting proposals and effecting change with your business background.

nurseyblues said:
Please don't take offense. Mind you that I said "some of what I've seen." To a degree, education is what you make of it, and you get out what you put in. I am not implying by any means that anyone who gets their BSN first is a bad nurse or can't perform patient care. Again, my article and my comments here refer mostly to working RNs returning to school, and also refers mostly to the online programs that are available now for working RNs.

Naturally, if you went BSN straight out of HS, then your program was also your RN program and would include all the required RN clinical portions. I am referring to those who are already nurses--diploma or ADN--who go back for a BSN right away through an online program or other RN-BSN program. I am not referring to HS to BSN, only RN to BSN. These programs, because they are for those who already have an RN, do not offer additional clinical experiences, which means that if an RN with minimal clinical skill goes in, a BSN with minimal clinical skill comes out.

There are inevitable problems when that nurse then tries to assume a role of leadership over nurses with strong clinical backgrounds and years of experience.

Again, I should have been very clear that my article and subsequent remarks are referring to RN-BSN education. I am talking about working bedside nurses who return to school to obtain only the BSN portion of their degree, which is almost always non-clinical since the student is already a practicing nurse.

Gotcha. And have seen that myself.

Specializes in Psych ICU, addictions.
Sirena922 said:
I have a question if anyone knows the answer; I have a Bachelors in Business and a Mastyers in Business. Would I have to go for a BSN or can I just get an Associates RN?

Technically, you could go for either the ADN or BSN. Either will lead to licensure as a RN.

However, more and more employers are requiring candidates with a minimum degree of BSN, so if you were to opt for the ADN, your employment prospects could be limited, especially in the larger cities.

Having previous degrees means that you'd be a great candidate for an accelerated BSN or accelerated MSN program. So you don't necessarily have to start from scratch and take 4 years.

Specializes in Education and oncology.

I'm about 1/2 through my DNP. I think there is no down side to more education and wish nursing as a profession started with the BSN at entry level. That being said, I taught at the associate level 16 semesters. There is merit to getting associate's degree but we lose respect from other professions because we're not always viewed as equals with ASN as acceptable. I know there will be flak but I don't believe nursing will be recognized as an equal profession in the medical community until BSN is mandatory. Have you even seen what physical and occupational therapists are required to do?? Doctorates. It's crazy.

Specializes in M/S, Pulmonary, Travel, Homecare, Psych..
oncnursemsn said:
I'm about 1/2 through my DNP. I think there is no down side to more education and wish nursing as a profession started with the BSN at entry level. That being said, I taught at the associate level 16 semesters. There is merit to getting associate's degree but we lose respect from other professions because we're not always viewed as equals with ASN as acceptable. I know there will be flak but I don't believe nursing will be recognized as an equal profession in the medical community until BSN is mandatory. Have you even seen what physical and occupational therapists are required to do?? Doctorates. It's crazy.

Even if it becomes mandatory, we'll still be in the same place.

Part of the reason is, yes, we'll never have the respect we crave. Other professions are always in a hurry to point out why you are not "as respectable". Human nature is all that is.

The primary reason though is: We have not even decided what BSN education is yet. No good mandating an unknown. No two BSN programs are anything alike. A few core similarities, sure, but mostly arbitrary educational requirements.

This is what keeps us on our knees begging for "respect". We're so undecided about what we are, so there is no need to worry about what others think. If we can't answer the question of who we are, we can't expect others to "respect" it.

AutumnApple said:
Even if it becomes mandatory, we'll still be in the same place.

Part of the reason is, yes, we'll never have the respect we crave. Other professions are always in a hurry to point out why you are not "as respectable". Human nature is all that is.

The primary reason though is: We have not even decided what BSN education is yet. No good mandating an unknown. No two BSN programs are anything alike. A few core similarities, sure, but mostly arbitrary educational requirements.

This is what keeps us on our knees begging for "respect". We're so undecided about what we are, so there is no need to worry about what others think. If we can't answer the question of who we are, we can't expect others to "respect" it.

I'm going to take it a very unpopular leap forward and say it's in part due to the very wide spectrum of competency, standards, characteristics, expectations and professionalism within the nursing industry. While there are differences in other professions, I don't think any are as wide as there are in the RN population.