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

[nurseyblues]

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.

[beemrdon]

I did an ADN program a few years ago and some of my classmates went on to get the BSN. I have been told by almost all of them that all you learn is how to write a better psy formatted paper. That is why the first two letters are "BS"...in nursing. It's a scam propagated by the schools. It's the same NCLEX either way. If I go on to another degree, it will be a bridge program for an NP. Your mileage may vary.

[smartnurse1982]

I guess I am one of the rare Rn's who think that Bsn and Adn programs should remain but have different focuses.

Maybe have Bsn programs focus on acute care and Adn program's focus on non acute,community based based care like LTC,home health,and out reach centers.

I actually think ADN Rns should have a similar role like Lpn's in non-acute care,but more expanded since we still have Rn licenses.

The only problem with that of course is what happens to Lpn's?

[BostonFNP, APRN]

AutumnApple said:

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".

Interesting, I have never had a single person mention that nursing is not a respectable profession.

[RNperdiem, RN]

More education is not a bad thing, but this education does not come for free. I think student debt is going to be the new subprime mortgages.

The discussion of return on investment is a relevant one.

[Libby1987]

smartnurse1982 said:

I guess I am one of the rare Rn's who think that Bsn and Adn programs should remain but have different focuses.

Maybe have Bsn programs focus on acute care and Adn program's focus on non acute,community based based care like LTC,home health,and out reach centers.

I actually think ADN Rns should have a similar role like Lpn's in non-acute care,but more expanded since we still have Rn licenses.

The only problem with that of course is what happens to Lpn's?

I don't know if you dismissed or simply missed my previous post re home health but it is more advanced than I think you're giving it credit.

quoting myself..

Quote

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.

[DoGoodThenGo]

Sadly the question of "is the BSN for everyone" is moot in many areas of the USA. Here in NYC as elsewhere at least for new grads good luck finding a hospital position at least without. LTC, nursing home and some other areas may prove more successful for a new ADN grad, and one that is enrolled in a bridge program may be able to land a new grad position.

When the question moves to a an experienced and well seasoned RN with an ADN or even diploma that is a whole other different can of worms.

[DoGoodThenGo]

Will also throw this out there as well.

Nursing is not unique in that many other forms of employment and or employers have made a four year degree the floor

for entry to all positions. Gofer, receptionist, secretary, mail room clerk, and all sorts of jobs including what once were routinely called "entry level".

There was a story in the New York Times about this a year or so ago. One place interviewed was a law firm somewhere in the South I believe. Every single new hire from the lowest to high had a four year degree including the mailroom kid/gofer.

This can perhaps be seen as an indictment against much of the primary and secondary education in the United States that employers now see a graduate with a four year degree having skills that once were common just out of high school. Employers also said (according to above mentioned news piece) that they felt those with four degree has having more "dedication" than those without.

There is also the larger issue that since the 1960's or so the United States has gone from having a four year degree as an exception to the normal.

Prior to WWII college was out of bounds for really all but the wealthy and or those who could get a scholarship or whatever. The GI Bill and other changes including financial aid of the post-war era changed that equation. This includes the spread of state and local public universities.

For a host of reasons the United States labor market seems awash in those with four year degrees so employers can use that as a tool to further screen potential employees.

It wasn't that long ago that "all BSN" mandates both imposed by hospitals and or the one state that tried it via statue failed. There simply were not enough local four year degree grads to fill slots, and thus places had staffing issues. Once the last famous nursing shortage hit the idea of making the BSN mandatory went out of the window for the one state that imposed such a requirement.

Thing seem different this time in that places for whatever reasons not only have imposed BSN mandates but are able to make them stick. Now we can debate how or if this has affected staffing, but thus far not one state BON or anyone else has stepped in to stop a facility from requiring the BSN.

[Kendraock]

While I commend nurses for getting more education I question the facilities forcing this on nurses. I've been a nurse for 22 years and feel my experience is more valuable than a degree. It's sad that employers are missing out on experienced nurses for a BSN after a name.

[AutumnApple]

BostonFNP said:

Interesting, I have never had a single person mention that nursing is not a respectable profession.

Hmph, it's been said to me many times via actions and attitudes, not so much by someone walking up to me and saying "Ha ha ha, nursing is NOT a profession" while they wring their hands together.

Do you honestly feel respected when you go to management or admin with a suggestion? Or do you get the same "I am busy with real problems, you're a nurse so go do nursing stuff" attitude most of us receive?

Do you feel respected when it comes time to make policy/procedure decisions (ones that largely affect nursing) or do you feel left out by your facility? Most facilities don't even invite us to the table when things are being discussed. Some do though, but unfortunately, the expectation is that we sit in the corner and mind our manners. Don't you dare suggest anything other than agreement with the status que. I've been around that block a couple times (being the one sent to sit in such meetings), wasn't impressed with what went on.

Do you feel respected when you see your facility throw a valuable co-worker under the bus for what was a system failure?

Do you feel respected when your facility cuts ancillary staff down to the bone, then fingers nursing as the ones who have to "pick up the pace and make up the difference"?

Do you feel respected by these grade school style surveys? Give great care to six patients, but get reprimanded for taking three instead of two minutes to answer the call bell of the seventh.

Does the practice of rewarding admin who have been around three years with six figure "bonuses", yet rewarding nurses who have been around for fifteen years with a plastic pin for their name tag make you feel respected?

I could go on forever. Point is, the scenario you present, someone tactlessly approaching you to announce "I don't respect nursing" isn't realistic. Who does that? And if the absence of that scenario is all you need to feel respected, then kudos to you. It's not enough for me though.

A handful of what you do outweighs a truck load of what you say.

I see too much disrespect via actions. Thats just me I guess.

Side note: I have had tactless people tell me nursing is not a very respectable profession. Mostly other hospital staff who, at the time I assumed were burnt out or just couldn't get along with nurses. Funny part is, they were telling me this "off the books" cause they were saying I was the exception. Very backhanded compliment.

[PearsonBSN]

All physicians have a "doctorate' degree. There is no such thing as an associate degree physician. I agree that the nursing profession is not respected. Sure, we are respected by society, but employers don't respect nurses. They just want warm bodies. Employers are just fortunate to have nurses who give 100% every shift. Employers are discriminate among the degrees. They prefer BSNs, but would kill for an MSN. ADNs are in full supply, but now they risk their accreditation if they have too many. It doesn't cost any more for a BSN and in some cases it's cheaper to hire a new BSN than to keep a tenured ADN. With these types of inconsistencies our profession will never get the respect we deserve from those who employ nurses.

[PearsonBSN]

smartnurse1982 said:

I guess I am one of the rare Rn's who think that Bsn and Adn programs should remain but have different focuses.

Maybe have Bsn programs focus on acute care and Adn program's focus on non acute,community based based care like LTC,home health,and out reach centers.

I actually think ADN Rns should have a similar role like Lpn's in non-acute care,but more expanded since we still have Rn licenses.

The only problem with that of course is what happens to Lpn's?

you make a good point. ADNs are only being affected in acute care facilities. Hospital nursing is the most desired and best paying jobs for ADNs, but BSNs have the education in organizations, systems and management which is better suited for entry level positions in hospitals. Perhaps Changing the focus of the respective degrees may better define the roles.

[Tommy5677]

My advice again.

If you want a BSN, do it as cheaply as possible by first getting the ADN at the local community college, then get the BSN online. Sometimes I wish I had done that but I'm retired so it doesn't matter anymore. Going to an expensive 4 year university is a waste of money and the reality is that nobody cares where your degree is from as long as you have it.

I lived in a professional bubble for 11 years. I was a health coach for a MedAdvantage population for a large insurance company and it was the best gig ever. When I left that position 2 years ago to move to the East Coast, and tried to get a job, nobody would even look at me even though my references were exemplary. Why? I don't have the BSN. I applied for the exact same position with another company in the same network,,, nothing. Not even a phone call. That's when I decided to just hang it up after 35 years. It was a good run and now I'm just over it.

Whatever you decide, don't stop with the ADN because you will ultimately regret it. Gone are the days of practically being hired on the spot wherever you go. That used to be my reality but not anymore. Good luck.