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.

[Palliative Care, DNP]

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?

Sadly, a Bachelors & Masters in business is not a BSN to a hospital system. Look into accelerated BSN programs. They are made for people with degrees in other fields.

[PearsonBSN]

Ddestiny said:

I agree. I'm finishing up my RN-to-BSN program this December and, beyond learning a little more about consuming research, I feel like it has been a total waste of time for me. I honestly would have dropped out after the first semester if I didn't want to go on to be a Nurse Practitioner later. The classes felt more like Gen Eds and I am so burnt out. I'm sure it will help me later on if we move somewhere where the BSN really is more of a requirement (it isn't here in KS), but for now it's just a financial and emotional drain without any real benefit (no raise, no new bedside job opportunities).

We must understand that the nursing profession is more than bedside care and clinical skills. It is about outcomes, education, and EBP improvements. There is an administrative side to nursing that is just as important as the clinical side. Doctors, lawyers, and pharmacists all practice at the highest degree possible. Nursing has too many different levels within the same license. Employers are not requiring BSNs because they are clinically superior to ADNs, because they are not. You will not learn any new clinical skills in the BSN program. What you will learn are more leadership, organization and management skills. This creates a more well rounded nurse. When a BSN doesn't cost the employer any more than an ADN, they are going to take the BSN. Especially when accreditation organizations want more BSNs.

[Ddestiny, BSN, RN]

PearsonBSN said:

We must understand that the nursing profession is more than bedside care and clinical skills. It is about outcomes, education, and EBP improvements. There is an administrative side to nursing that is just as important as the clinical side. Doctors, lawyers, and pharmacists all practice at the highest degree possible. Nursing has too many different levels within the same license. Employers are not requiring BSNs because they are clinically superior to ADNs, because they are not. You will not learn any new clinical skills in the BSN program. What you will learn are more leadership, organization and management skills. This creates a more well rounded nurse. When a BSN doesn't cost the employer any more than an ADN, they are going to take the BSN. Especially when accreditation organizations want more BSNs.

Thank you for the response. I understand all this....now.

Going into the program I thought it would be more like my LPN and RN programs, without the clinicals. When I was told I'd already taken "too many" pathophysiology classes, I learned otherwise.

I understand that there are other components of nursing (business, management, etc), but those components are not for me, and thus I wouldn't seek them out on my own.

That, plus the fact that it seems like in almost every class we get the whole spiel about how patients have better outcomes with BSN-prepared RNs than with ADN-prepared RNs....Maybe it's just my program, but it seems pretty elitist. I can see how any nurse that wants to go on and invest in themselves as a nurse is probably going to care more about patient outcomes and maybe even be more knowledgeable, but you definitely aren't getting that knowledge in the program.

Nursing school (LPN, ADN) was hard but I enjoyed the challenge because I felt it was applicable. I'm burnt out because this, to me, isn't.

And thus I'm here *****ing on this forum. lol

[AutumnApple]

momof2divas said:

Penn State RN-BSN does require clinicals. I am currently a student with their online program and its been very good. Their are programs that do require a clinical practicum.

I applied to that program myself actually. Had a friend (years ago) who went through it.

The situation I described, where schools give students planet sized loop holes to jump through to avoid clinical hours: Penn State is a rare exception.

They are not willing to lower their standards to fill the seats. I respected that actually. Truth is, from what I understand, they can be this way because even when they stick to their standards, the seats get filled.

It's a question of "Which came first, the chicken or the egg?" but, I think the reason they got to where they are (always having a full class) is because they refuse to lower their standards.

I very much wanted to go there despite the fact that, yes, I would have had to do clinical hours. Cost was the deciding factor for me. The school I ended up going to was very respected but not as big and, well, I wanted less school loans to repay.

[DoGoodThenGo]

PearsonBSN said:

We must understand that the nursing profession is more than bedside care and clinical skills. It is about outcomes, education, and EBP improvements. There is an administrative side to nursing that is just as important as the clinical side. Doctors, lawyers, and pharmacists all practice at the highest degree possible. Nursing has too many different levels within the same license. Employers are not requiring BSNs because they are clinically superior to ADNs, because they are not. You will not learn any new clinical skills in the BSN program. What you will learn are more leadership, organization and management skills. This creates a more well rounded nurse. When a BSN doesn't cost the employer any more than an ADN, they are going to take the BSN. Especially when accreditation organizations want more BSNs.

You do realize that there were diploma grads for decades that had those skills in spades. So much so in terms of ranking/grouping diploma and BSN graduates were on average put in the same level.

Diploma graduates ran floors and or units in both supervisory and administrative capacity. They also ran entire hospitals though in later years they would likely have gone back for their BSN. Yes, some diploma grads took college courses to round out/continue their education, but nothing like being forced to return for another two years worth of classes.

[DoGoodThenGo]

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?

Years ago you could have just gone for the ADN and found work in most areas of the country soon as you had your license. Sadly in many areas that is no longer the case as places want the BSN at least for new grads.

Know of about ten RNs who made "mid-life career changes" in the 1990's. Everything from FDNY, NYPD, to executives; since they all had four year degrees and didn't want to spend the time and money getting a BSN, the went the ADN route. This is in NYC and all got jobs upon graduation. Now don't think that is possible, at least not here.

[PearsonBSN]

You do realize that there were diploma grads for decades that had those skills in spades. So much so in terms of ranking/grouping diploma and BSN graduates were on average put in the same level.

Diploma graduates ran floors and or units in both supervisory and administrative capacity. They also ran entire hospitals though in later years they would likely have gone back for their BSN. Yes, some diploma grads took college courses to round out/continue their education, but nothing like being forced to return for another two years worth of classes

The bottom line is, the trend is moving towards BSN. Those who choose not to comply will get left behind. The trend is gaining momentum. If you want to work in an acute care facility as an RN, you're going to have to have a BSN. The employers have no loyalty to you. They don't create positions that fit your level of education. You have to have the skills and degree they want, and those requirements can and will change ant any time. I resisted for years. I felt my ADN was sufficient enough. After almost 20 years, I finally went back to school and got my BSN and I kept asking myself why did I wait so long? Before my BSN, I didn't know what I didn't know. Now I have a better understanding. ADNs will have to accept that they don't have to get aBSN if they don't want to, but the employment opportunities in acute care facilities will be limited.

[subee, MSN, CRNA]

For all those complaining about the cost of education: What's it worth to have a job you can retire with? If you can afford to retire at 45 and your area starts to hire BSN only for acute care you'll be dandy even if you can't get a job. Good grief. It's the 21st century and things change. Not that long ago, one could clerk to become a lawyer but I don't know if you many young people are STILL complaining they have to actually go to law school. As long as we are a cheap commodity, working conditions will never change.

[AutumnApple]

subee said:

For all those complaining about the cost of education: What's it worth to have a job you can retire with? If you can afford to retire at 45 and your area starts to hire BSN only for acute care you'll be dandy even if you can't get a job. Good grief. It's the 21st century and things change. Not that long ago, one could clerk to become a lawyer but I don't know if you many young people are STILL complaining they have to actually go to law school. As long as we are a cheap commodity, working conditions will never change.

I'm not making the correlation between more expensive education and better working conditions. Can you expand?

From what I've seen, the only people who benefit from higher education costs is the schools giving said education. Healthcare facilities don't look at our tuition bill and say "Oh, look at that, better improve the nurse to patient ratios!".

In fact, quite the opposite tends to go on. Conditions are getting worse while BSN for bedside care continues to be pushed. I guess they (healthcare facilities) don't see the connection either.

[rhellner57]

When I graduated from a diploma program, getting my BSN was most distant thing from my mind. Over the years , I waffled between getting a higher degree and continuing doing what I loved; labor and delivery, mother/baby care. I took a few classes periodically but when the money became tight, would take time off. As a traveler, I was encouraged to pursue a degree and financially was assisted in a great way. I recently graduated from an on-line program taking 1 class every 8 weeks over nearly 3.5 years. I can say that there was a few classes that were eye-opening and beneficial is advancing some of my nursing skills but the majority of the courses were not going to change the way I already care for my mothers and babies: with personal compassion for their comfort and care. Most of these classes taught me how to write a good paper and how to fit working, adapting to a new travel assignment, participating in family activities etc. managing myself while excelling in my classwork ( by the way I did graduate with honors at age 59). Necessary, maybe for a great opportunity in the travel field, required to be a good, caring, compassionate nurse - not so much.

[Libby1987]

If prospective students would consider the market and boycott the for-profit schools limiting the production of new grads to the number of brick and mortar BSN programs, we'd have more negotiating power from a supply and demand standpoint.

Will never happen because a rare few look at the big picture and the vast majority are self focused in getting in anyway they can despite the working conditions.

[subee, MSN, CRNA]

AutumnApple said:

I'm not making the correlation between more expensive education and better working conditions. Can you expand?

From what I've seen, the only people who benefit from higher education costs is the schools giving said education. Healthcare facilities don't look at our tuition bill and say "Oh, look at that, better improve the nurse to patient ratios!".

In fact, quite the opposite tends to go on. Conditions are getting worse while BSN for bedside care continues to be pushed. I guess they (healthcare facilities) don't see the connection either.

When we start cranking out less nurses, we become more valuable to the employer. Like what the physical therapists have done. With community colleges cranking graduates out, employers have little incentive to keep their staff satisfied. California has achieved a stable work force in their hospitals. Very low staff turnover. That's good for everyone..

...except new grad.