Is it true that a BSN will be mandatory soon?

DeniseRNBSN · Feb 10, 2005

I like all of your ideas, too. A very close relative of mine is a Social Worker. She went to school for 4 years, made top grades in her class--and makes as much money as a CNA, as well as having clients who can be violent. So if Social Workers or teachers are any indication, education doesn't garner "respect."
This has been a general misconception of women since the Feminist Movement began, and coming out of the "dark ages," I can tell you all quite frankly that education is not the key driver in gaining "respect" for our profession.

Social work is one of those fields where you have to have a Master's degree in order to make money. (sort of like a psychologist).

My sister is a social worker with a masters degree and made $75000 her first year here in Florida.

She is has respect from her peers because she has a masters degree. Too bad the same can't be said for nursing.

That's why I think nursing should be paid according to degree, certification, specialty, and to some extent experience.

rstewart · Feb 10, 2005

Social work is one of those fields where you have to have a Master's degree in order to make money.
My sister is a social worker with a masters degree and made $75000 her first year here in Florida.
She is has respect from her peers because she has a masters degree. Too bad the same can't be said for nursing.
That's why I think nursing should be paid according to degree, certification, specialty, and to some extent experience.

"One of those fields where you have to have a Master's degree in order to make money?" lololol So you would agree that in certain fields a Bachelors degree may hold limited value. Actually, I tend to agree, hence my proposal above.

On a more serious note, your sister is due respect and congratulations, but certainly not because she holds a Masters Degree. The fact is she earns significantly more than the median MSW salary in Florida. Indeed her salary exceeds the usual upper range for that profession in that state no doubt making her a statistical outlier.

In Florida, the average (median) MSW earns about the same as a staff nurse in an intensive care unit----who may or may not even possess a Bachelors level degree (BSN).

So one might wish for such an ordered world where an individual should be paid according to the highest degree held......"and to some extent experience." In my view this would be folly, and in any event the relationship clearly does not hold true in the real world.

USFguy · Feb 10, 2005

I totally agree with your post.
Nursing is not taking seriously because there are so many ways to become a nurse.
Then may I offer some modest proposals?
I suggest that there be only one route to the title/license Registered Nurse: the Associates Degree. Associates Degree prepared RNs have for decades demonstrated the ability to provide excellent patient care throughout the entire continuum of care. Even with the tremendous advances in technology we have witnessed, nurses prepared at that level have met every challenge. Additionally, such programs can deliver nurses to the bedside where they are most needed in a relatively short time, a particularly attractive feature during a shortage. Shorter programs result in lower cost which is likewise a benefit to society since many institutions of higher learning are highly subsidized. And for the student, in this day and age lower cost often translates to lower student loan debt to be repaid. This approach would also promote much needed diversity in Registered Nursing's ranks since history shows this level is more accessable to low income students and minorities. Since AD preparation is time proven with respect to successfully passing NCLEX and transitioning to successful bedside nursing practitioners, I see no valid reason why they should not retain the title Registered Nurse in an unaltered form. They are well educated to perform safe/competent and professional bedside nursing.
On the other hand, in my proposed educational model the BSN would cease to exist. In its stead I would have a program, three years in length which awarded a Masters degree with limited and understandable "tracks": Education & Research track, Clinical Specialist track, and an Administration/Management track. Application to these professional schools would be limited to AD prepared nurses only and they must have completed at least 3 years of hospital based nursing at the bedside. There will be no more individuals who go straight through to a Masters without demonstrating that they can successfully take care of patients; And no more accelerated programs for those with non nursing degrees. As described above, the road to nursing leadership would be proven competency as a Registered Nurse----in my view that requires both education and hands on experience. Those completing the Masters level program would have the opportunity to sit for certification examinations in their specialties. In turn, the Masters prepared, certified nurses would make application for an additional license to practice in their new role. The new titlies would in no way diminish the value of the Registered Nurse title as for example, Registered Professional Nurse (Masters) vs Registered Nurse (AD). Rather, the license will clearly define what work the Masters prepared nurse is certified to safely and competently perform.
Frankly, I see the BSN as neither fish nor fowl. It is said, for example, that it should be required for management positions. Yet, there is little in the curriculum to support this reasoning. There are no required accounting courses. And there are no required personnel management courses. No business law courses. The sad truth be known, that leadership rotation where a nurse shadows a manager etc. is often an exercise in the blind leading the blind. Similarly, in the area of research, an elementary statistics course and a limited exposure to experimental design do not a researcher make, nor even an informed reader. Time limitations result in a product of limited value except in the context of providing a background for still more research courses. And finally, in the case of clinical competency, I do not believe an argument can be made rationally that demonstrates the superiority of BSN prepared nurses over those otherwise prepared. But clearly there would be time in a 3 year program for Registered Nurses with 3 years+ experience to satisfy nursing's toughest critics.
So yes, I say, let's have but one entry point for the professional Registered Nurse-------but make that point the Associate's Degree.
I have been following this discussion and this is the most intersting post I have come accross.
I am currently a second semester sophmore in the Bachelor of Science in Nursing program at University of San Francisco.
I agree with you. The nurse leadership (i.e. management) course as well as the nursing reseach and pre-requisite intorductory statistics course certainly don't qualify one for a management postion.
Most of the hospitals here in the San Francisco Bay Area (I'm sure hospitals elsewhere, through out the country have different standards) will not hire a nurse who simply has his/her BSN for a management post. They require a MSN in Healthcare Administration or Nursing Informatics, etc.
I find it rather odd though that foreign nurses are indeed required to have a BSN in order to apply for an H1 visa, allowing them to work in the United States. So, in that instance, many if not all foreign nurses working here as your colleagues will have a more education than you as an ADN or Diploma nurse (I am not talking about you directly as I don't know your level of education).
The fact is that most of the industrialized world requires nurses to have a baccalaureate degree, and yes...even the Phillippinnes--which, by the way, has a curriculum very similar to the United States (being a former colony) and therefore sends over the highest number.
ADN nurses may see nursing theory as not readily being useful in their daily practice as a bedside/floor nurse, but it is theoretical/conceptual/philosophical coursework like this that distinguishes a technician (someone who can perform routine clinical work...NG's, vitals, charting, etc.) from a professional.
Talk to any physician and ask them if they have read Dante, Shakespeare, or are able to make a powerpoint presentation, conduct preliminary research, etc. They will answer yes and many ADN nurses will answer no. ( I know that sounds very elitist, but really folks...)
And then the ADN nurses will ask what the heck does knowing all that have to do with nursing and the answer is everything. Everything you study in life will not always have a direct connection to the actual work of your chosen career. But the education you acquired does count and I promise you that you will find yourself drawing upon it without thinking at times, finding abstractions that help clarify gray areas in your practice.
This is the purpose of a liberal arts and sciences education. It equips you to better understand the world in which you will work. This is essential to any person choosing to "PROFESS" (this is where the term "professional"originates) a particular line of work.
It's time to raise the bar and require the minimal level of education needed to truly call oneself a "professional," which is namely the BSN.
Let's clear something up. The NCLEX represents the minimum standards required of a nurse to practice in a particular state. The fact the ADN and BSN nurses both take and pass the same exam, says nothing about their level of education. Passing the NCLEX ensures the state that you are able to practice sufficiently enough and won't kill someone. Many BSN programs require their students to pass their own examination before graduating, which is usually much broader in scope and harder than the NCLEX. At my school, USF, this is called the HESII exam.
While we are discussing the possibility of raising the educational attainment up from the Associate of Science Degree in Nursing to the Bachelor of Science in Nursing, we should begin the process of moving all of the Graduate Advanced Clinical Specialties (Nurse Anesthetists, Nurse Practioners, Nurse Midwives, and Clinical Nurse Specialists) up from Master Degrees to Clinical or Practice Doctorates. This has already been proposed by the AACN (American Association of Colleges of Nursing) and is slated to begin the phase out period in 2015. Eight schools of nursing already offer the DNP or DrNP (Doctor of Nursing Practice) and the ND (Doctor of Nursing--slated to be phased out in favor of the DNP/DrNP). This doctorate would represent the highest level of practice in nursing and would differ from the research based PhD or DNS/DNSc currently offered to APN's (Advanced Practice Nurses). Finally nursing would mirror the rest of the Allied Health Professions who have already made the move to the clinical/practice doctorate such as physical therapists (DPT), Audiologists (AuD), Pharmacists (PharmD), and of course, the oldest among healthcare next to nurses, Physicians (MD/DO).
Another note about nursing not garnering enough respect due to being a female dominated profession. This is true as teachers, secretaries, homemakers, receptionists, flight attendants, and other fields passed off as "womens work" don't recieve much respect either. The number one reason nursing has a hard time recruiting men into the field (actually into any of the above refrenced fields for that matter) is because of the pay. Most men can get over the sexist stigma of performing women's work if they are paid adequately (I don't speak for all). But nurses aren't compensated fairly and really don't fight for more. Studies have shown time and again that women are more prone to accept less pay in order to seem modest and conform with the sterotypical role of a female (this is internalized from all the years of istitutionalized sexism). This precisley the reason why nurse anesthetists (45% men--and you wonder where are all the men in nursing?!) earn salaries well into the upper hundred thousands and lower two hundred thousands--because men demand adequate compensation and aren't afraid to fight for it. Of course, we don't have to deal with centuries of internalized genderization, but this is why nurses, and all female dominated fields have temendous issues with public respect and adequate pay.
Times are changing and more and more women are fearlessly and boldly stepping up to the plate, but not enough to turn the tides in nursing. Not yet.
The BSN and DNP are a good starting place.

DeniseRNBSN · Feb 10, 2005

"ADN nurses may see nursing theory as not readily being useful in their daily practice as a bedside/floor nurse, but it is theoretical/conceptual/philosophical coursework like this that distinguishes a technician (someone who can perform routine clinical work...NG's, vitals, charting, etc.) from a professional.

Talk to any physician and ask them if they have read Dante, Shakespeare, or are able to make a powerpoint presentation, conduct preliminary research, etc. They will answer yes and many ADN nurses will answer no. ( I know that sounds very elitist, but really folks...)

And then the ADN nurses will ask what the heck does knowing all that have to do with nursing and the answer is everything. Everything you study in life will not always have a direct connection to the actual work of your chosen career. But the education you acquired does count and I promise you that you will find yourself drawing upon it without thinking at times, finding abstractions that help clarify gray areas in your practice.

This is the purpose of a liberal arts and sciences education. It equips you to better understand the world in which you will work. This is essential to any person choosing to "PROFESS" (this is where the term "professional"originates) a particular line of work.

It's time to raise the bar and require the minimal level of education needed to truly call oneself a "professional," which is namely the BSN."

I totally agree with your post.

Anyone can go to school for 1 to 2 years and be taught to perform tasks, but the BSN goes further and your thinking skills go beyond task oriented behavior.

Many nurses feel that we are all equal when we, by definition, are not. There is a reason that the LPN program is 1 year long, the ADN program 2 years, and the BSN program 4 years.

The LPN is a concrete thinker and it progresses with the BSN learning to think more abstractly. The Master's and Doctorate programs go even further with their philosopical stance. All of this is VERY useful when you're in the clinical setting dealing with patient's and their families and many life or death situations.

I'm looking forward to the day when the BSN is the minimal requirement for nursing.

Denise RN, BSN, CCRN

txspadequeenRN, BSN, RN · Feb 10, 2005

"I'm looking forward to the day when the BSN is the minimal requirement for nursing."

This is something that will never happen or the US will have a major, rip roaring shortage. Just because you have a BSN does not make you a nursing God; you have to know how to use it first. All these liberal arts classes I have been required to take as a future BSN nurse, is preperation for what ? Maybe I can rattle off philosophy or let my patients induldge their sickness into the best theater performace ever performed on the 7a to 7p shift. How about reading them stories of literature, I can share anaylization and we can create themes between vomiting episodes. Now people before you beat me down. I am working on my BSN and I just dont feel that more liberal arts will better patient care. However. you remove a year of liberal arts and replace that with clinicals ... that is solid. Bottom line here .. We need nurses with solid clinical skills and nurses that are not afraid to get in and handle patient care. Patients could care less if you have a solid liberal arts foundation, but I guarentee they care how your IV skills are!!!!

:sofahider ....

medpsychRN · Feb 11, 2005

I think you are equating one's ability to abstract with education. I readily agree my eleven year old grandson does not have the ability to see the consequences of actions. However, this comes with age.

There are no LPN's on my unit. There are PCT's and CNA's. In a busy med/psych unit, I do not have the time to monitor their every interaction. In this instance, they have to be more than concrete thinkers. Although they may be assigned to take vitals, accu checks and ADL's, just performing these tasks forces a verbal interaction with some very difficult, treatment refractory, delusional bipolar patients. If you are just a concrete thinker, you're in trouble.

Because I work in a university hospital, I am exposed to nurses with various degrees. I had the opportunity to work with a nurse who had her doctorate, was employed part time as a psych clinical teacher (teaching BSN students) who was also working the floor to supplement her income. She often became emeshed with patients, spending time in an attempt to provide therapy. She became angry when her patients did not follow her suggestions and behavioral instructions. It was an unrealistic expection for a borderline of 20 plus years to suddenly change her behavior in two weeks time. Most, if not all of our patients have been involved in all sorts of long term therapy. Beyond her efforts to reform borderlines, she made frequent mistakes.

You would think a nurse with her doctorate, actively involved in teaching in the same environment she is employed would be aware of appropriate interventions. She would have good boundaries and know a patient's actions or inactions do not reflect on her. She would be careful in passing medication and remember to chart her meds and take off orders.

But, she didn't. The question of the thread centers on mandatory BSN and those in favor believe furthering one's education is the probable answer to ensuring better patient care. If this hypothesis holds true, she would be the answer to a patient's dream.

I certainly support anyone in their desire to further their education. I have met some amazingly intelligent nurses. And I welcome each and every opportunity as I am hoping to learn from them. But, I am acutely aware the initials after one's name does not guarantee they can do the job. I respect the people I work with regardless of their educational background. And...yes, I have my bachelor's.

rstewart · Feb 11, 2005

Anyone can go to school for 1 to 2 years and be taught to perform tasks, but the BSN goes further and your thinking skills go beyond task oriented behavior.

Many nurses feel that we are all equal when we, by definition, are not. There is a reason that the LPN program is 1 year long, the ADN program 2 years, and the BSN program 4 years.

The LPN is a concrete thinker and it progresses with the BSN learning to think more abstractly. The Master's and Doctorate programs go even further with their philosopical stance. All of this is VERY useful when you're in the clinical setting dealing with patient's and their families and many life or death situations.

Now then I would encourage all nurses to read this post, in fact review all the previous posts on this thread. Can there be any doubt from which level of nursing eminates the divisivness which plagues the nursing profession?

There is no evidence that obtaining a BSN improves abstract thought processes. I would appreciate the opportunity to examine the experimental design of any study which comes to that conclusion. In the absence of such evidence, I regretfully must conclude that you are mindlessly regurgitating the unsupported ramblings of nursing academia.

The fact of the matter is the very existence of Associate degree prepared nurses is a testament to the failures of BSN education, specifically 1) The dismal failure to attract and educate sufficient numbers of competent bedside nurses despite repeated assurances they can do otherwise and 2) The inability to measurably distinguish themselves from alternatively prepared nurses. I should add at this time that studies such as Akins which attempt to demonstate such differences are of such noticeably poor design, that even a novice researcher can spot their limitations. However, for those individuals who are incapable of making such analysis independently, a visit to the National Organization for Associate Degree Nursing website might be helpful.

The idea that AD prepared Registered Nurses (or any nurse for that matter)perform only at the task level is at once offensive and unsupported by the literature. The idiocy of such a proposition is evident to all but those with an agenda to support.

USFguy · Feb 11, 2005

Anyone can go to school for 1 to 2 years and be taught to perform tasks, but the BSN goes further and your thinking skills go beyond task oriented behavior.
Many nurses feel that we are all equal when we, by definition, are not. There is a reason that the LPN program is 1 year long, the ADN program 2 years, and the BSN program 4 years.
The LPN is a concrete thinker and it progresses with the BSN learning to think more abstractly. The Master's and Doctorate programs go even further with their philosopical stance. All of this is VERY useful when you're in the clinical setting dealing with patient's and their families and many life or death situations.
Now then I would encourage all nurses to read this post, in fact review all the previous posts on this thread. Can there be any doubt from which level of nursing eminates the divisivness which plagues the nursing profession?
There is no evidence that obtaining a BSN improves abstract thought processes. I would appreciate the opportunity to examine the experimental design of any study which comes to that conclusion. In the absence of such evidence, I regretfully must conclude that you are mindlessly regurgitating the unsupported ramblings of nursing academia.
The fact of the matter is the very existence of Associate degree prepared nurses is a testament to the failures of BSN education, specifically 1) The dismal failure to attract and educate sufficient numbers of competent bedside nurses despite repeated assurances they can do otherwise and 2) The inability to measurably distinguish themselves from alternatively prepared nurses. I should add at this time that studies such as Akins which attempt to demonstate such differences are of such noticeably poor design, that even a novice researcher can spot their limitations. However, for those individuals who are incapable of making such analysis independently, a visit to the National Organization for Associate Degree Nursing website might be helpful.
The idea that AD prepared Registered Nurses (or any nurse for that matter)perform only at the task level is at once offensive and unsupported by the literature. The idiocy of such a proposition is evident to all but those with an agenda to support.

I really find it hard to believe nurses are fighting tooth and nail to keep their education at the Associate Degree level!! It is mind boggeling!! It's like your'e all proud to be on the bottom rung of health care, because that is truly where you/we will be and remain if your/our stubborn ignorance towards higher education continues, as it has for the past 30 some years.

This is about the future of nursing. Don't short change yourselves! As I said earlier, the rest of the world understands that nurses need four years of education. Why doesn't America get it yet?!

Education = Power.....PERIOD

You want higher pay, more prestige and respect from your colleagues and the public, you want more men in nursing......the answer is simple, more education!!!

Mandatory BSN for all nurses NOW!!!

medpsychRN · Feb 11, 2005

The clinical time is the same whether you are an ADN or a BSN. ADN's can and do provide the same patient care. I believe if the BSN program allowed people to specialize and had additional clinical time it would be more attractive.

Unfortunately, at least where I work, there is no advantage to having a BSN. You cannot hold a management position so you are going to work the floor along with the ADN and perhaps make a dollar an hour more. You just don't get the financial return on an advanced nursing degree. If you're thinking get a master's, you may then be eligible for management but those jobs (where I work) are few and far between. Many of the nurses on my unit have their master's.

Some degree nurses have a holier than thou attitude (which I don't get from the MD's) and people find this abrasive.

Knowledge equals power and frankly, those initials after your name regardless of what they are doesn't always mean you know what you're doing.

icyounurse, BSN, RN · Feb 11, 2005

i worked my butt off for three years to get my adn and am now going back for by bsn. but only because i want to go to grad school, not because i think there is that much of a differance between an adn vs bsn. in my case the only classes i was missing were macroeconomics, business statistics, literature, 2 histories and a nursing management course. other than the nursing management, the nursing related curriculum was the same.we took the same science courses. the clinicals were the same. and the starting pay was 25 cents more for a bsn, that is it. and guess what?same boards, same liscence. it was amazing how many people i work with who have their bsn think that their education was so superior. i disagree.

i would say that i am just as qualified as anyone with their bsn, and all this nonsense about "better educated nurses"

pure snobbery.

sincerily,

proud to be adn

miya · Feb 12, 2005

any suggestions as to where i can find some facts, do some of my own research? I'm about to start my pre-reqs for my ADN and have some serious concerns (I'm in NY).

Claver · Feb 12, 2005

The most important element of nursing is passing your state boards - Diploma, ADN, BSN all take the same boards - this indicate that we all have the same basic educational requirements - I am a diploma trained nurse - trained in the days when this was the minimum requirements for practice - with my years of clinical experience I would say that I need to be paid more than any BSN - because on the job we are doing the same thing and I have years of clinical experience, supervisory, independent, consultant, educator etc. - but that is not the point I want to make - many diploma and ADN nurses have furthered their education in health related fields - and this mean that many of them have the skills and ability to be managers - I have a bachelors and a masters degree in health adminstration and am currently enrolled in a Phd program.

We cannot get rid of the "old" without considering where we have come from - We need to stop this debate and look to see how we can empower ourselves - and a million degrees are not going to do this - as posted earlier we must be seen as 'BILLABLE HOURS" and so we have to work on getting hospitals etc. to acknowledge this - Many people who rise to top positions do not necessarily have all of these degrees - the former police commissioner of New York City, the National Security Director in New Jersey under the former administration - and we can go on and on. Let us think seriously about this degree business - not that it is not needed - but BSN'S just think of this - in the next 25 years someone will be saying that you need A MSN to enter practice - DIPLOMA AND ADN'S WILL BE EXTINCT - BSN'S WILL BE GRANDFATHERED IN - THEN IN THE NEXT 25 YEARS - A PHD WILL BE THE MINIMUM TO ENTER PRACTICE - BSN'S WILL BE EXTINCT AND MSN'S WILL BE GRANFATHERED IN and on and on

WE NEED TO UNITE - accept our history and diversity and MOVE ON

:rotfl: :rotfl: :rotfl:

I totally agree with your post.
Nursing is not taking seriously because there are so many ways to become a nurse. It only takes 1 year to say that you are a nurse.
Name one other job where you can go to a vocation/technical school for one year and become a PROFESSIONAL and be treated with the utmost dignity and respect?
I can't name a one. That's why nurses don't get the respect or the money that we deserve. That's why there is no difference in pay between a diploma grad and a BSN.
Yes, there is a nursing shortage and there will probably always be one but does that mean we cut the education level to achieve the goal of more nurses?
There is no way that medical schools will cut their education requirement because of a physician shortage. Does it take one year to become a lawyer, teacher, chemist, engineer? (I could go on).
Nurses should not sell ourselves short by only requiring one year to become a nurse. I think New York is doing the right thing by requiring their nurses to have a BSN.
When ALL nurses are on the same playing field educationally we can then command more autonomy, respect, and monetary incentives.
Denise RN, BSN, CCRN