Nursing Degrees: The Hospital-Based Nursing Diploma (RN)

Persons who wish to become registered nurses in the US have four prelicensure academic options from which to choose: diploma nursing programs, associate's degree programs, baccalaureate degree programs, or entry-level master's degree programs. This piece will explore the diploma nursing program, which is the only type of non-degree program remaining in the US that results in professional licensure as an RN.

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Nursing Degrees: The Hospital-Based Nursing Diploma (RN)

A registered nurse (RN) is a multifaceted healthcare professional who has satisfactorily completed a nursing program and obtained occupational licensing to render care to patients across the life span. The RN has a myriad of responsibilities including collaboration, health promotion, patient advocacy, disease prevention, client and family education, and formulation of the plan of care.

RNs who provide bedside care complete assessments, monitoring, documentation, reporting of changes in condition, interventions, procedural skills, medication administration, treatments, education, discharge instructions, and continual evaluation of progress toward goals. RNs can be found working in various healthcare settings such as acute care hospitals, extended care facilities, hospice, home health, private duty, psychiatric hospitals, clinics, doctors offices, occupational health sites, birthing centers and virtually any place where nursing care is needed.

On the other hand, RNs who do not work in direct patient care can be employed as hospital/unit educators, professors, clinical instructors, case managers, unit managers, directors of nursing, chief nursing officers, staff development coordinators, researchers, state surveyors, infection control clinicians, and a whole host of other non-bedside positions. Non-healthcare workplace settings that utilize RNs include schools, laboratories, insurance companies, jails, prisons, private homes, military deployments, office parks, research centers and an entire multitude of other locations.

People who are interested in becoming RNs in the United States have four educational options from which to select. Students may choose to apply to a diploma nursing program, an associate's degree program, a baccalaureate degree program, or an entry-level master's degree program. Graduates of all four types of prelicensure programs must achieve a passing score on the same national exam to obtain nursing licensure. This piece will discuss the diploma nursing program, which is the only type of non-degree program remaining in the US that leads to licensing as an RN.

The three-year hospital-based diploma nursing program is the oldest kind of prelicensure training in existence today, dating back to the 19th century. The typical diploma program lasts anywhere from two to three years in length, is conducted in a hospital school of nursing, allows students to amass a very high proportion of clinical hours compared to other types of training, and results in conferral of a diploma upon satisfactory completion. Keep in mind that the number of diploma nursing programs has been diminishing gradually over the past few decades; as a matter of fact, they now make up less than 10 percent of all prelicensure nursing programs in the US. This is because nursing education and training has largely moved away from the hospital setting and into the college setting.

Nursing programs that lead to the diploma normally consist of curriculum that includes a blend of classroom theory and hands-on clinical practicum to adequately educate and train minimally competent, generalist nurses for all types of healthcare settings. The coursework usually includes subjects such as:

  • Hands-On Clinical Practicum
  • Medical-Surgical Nursing (Adult / Pediatric)
  • Psychiatric / Mental Health Nursing
  • Pediatric Nursing
  • Pharmacology
  • Nursing Fundamentals
  • Geriatric Nursing
  • Maternal Health / Obstetric Nursing
  • Pathophysiology

Most modern-day hospital-based diploma nursing programs have articulation agreements with nearby colleges and universities to promote seamless transfer of credits and facilitation of admissions to degree completion programs. Click on the website link below to read about the diploma program offered at the Bridgeport Hospital School of Nursing in Connecticut.

RESOURCES

VickyRN. (2009, September 7). Entry Into Practice: Diploma Programs for Registered Nursing. Retrieved April 15, 2014, from https://allnurses.com/entry-practice-diploma-programs-registered-t296715/

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TheCommuter

About TheCommuter, BSN, RN

TheCommuter, BSN, RN, CRRN is a longtime physical rehabilitation nurse who has varied experiences upon which to draw for her articles. She was an LPN/LVN for more than four years prior to becoming a Registered Nurse.

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I have read that high-paying jobs for nurses are non-clinical. Is it true?

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amygarside said:
I have read that high-paying jobs for nurses are non-clinical. Is it true?

Maybe yes, maybe no. You really can't make that sort of generalization.

Here are two clinical examples: An experienced critical care nurse in Boston can earn over $100K/year. A successful case manager in private practice can earn between $60-120K/year.

I have not worked bedside for years, and have earned (variously) between $53K and $146K/year in today's dollars. I have colleagues who regularly earn $400K/year in legal nursing as independent consultants. I have other such colleagues who earn around $90K...but most of that is their day jobs, and they pull in about $18K from legal nursing. Go figure.

(Note: all of the above have at least a BSN, and some are MSN)

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Specializes in Maternal Child Health, GYN.

As a diploma trained RN I can certainly appreciate this article. Well said!! I believe I was adequately trained in the clinical areas to be able to start my nursing career comfortably. Over the years I have experienced a number of changes in the way we deliver care at the bed side but the basic foundation of hands on nursing care and clinical expertise has only improved with the time. I believe that continuing education and advance degrees will make it even better. The key is to maintain the focus of why we are nurses in the first place and never lose sight of that vision.

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As someone interested in progressing to the RN level, it seems to me that a hospital based diploma program is education by immersion. I love it. Perhaps hospital based diploma followed by entry into BSN should be the standard. When you live and breathe something for a period of time it becomes second nature. BSN programs produce good nurses, but many of them come out unsure of basic skills like bedside manner. To the PTB running the magnet program, consider this option for patient care improvement. To the money hungry hospitals, think of the revenue if you do this!

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Our hospital just did away with the Nursing Diploma progr they offered. Now only one of the three left in my state.

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The removal of the Dip He and going to degree has been debated to death. But i bet there are a lot of diploma nurses out there who have no intention going back to university to top up to a degree. Just out of curiosity does anyone ever think it will get to a stage where diploma nurses wont be allowed to practice and have to move to this worrying associate practitioner role that is being discussed? I believe something similar happened with the state registered and enrolled nurses qualifications, is that correct?

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Specializes in Medical and general practice now LTC.

EN became RN level 2 and kept their jobs however I believe those that didn't want to bridge to RN had no alternative but stay in the job they had because all jobs advertised where RN1. I bridged to RN approx 10 years after getting EN and now doing RN to BSN as here in Canada hard to move forward without it

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That's interesting. could stay in the job they are in but couldn't go and get another one. this career doesn't half have some quirks.

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Question...I am an on call hospice nurse. I work 125.5 hors q2weeks. I usually work one week on/one week off. What is the acceptable pay rate? I've been doing this for something I am no longer to live on. Been doing this for 2 years. What do other people make? I get $10 beeper rate, then perhaps visit rate

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Cynde said:
Question...I am an on call hospice nurse. I work 125.5 hors q2weeks. I usually work one week on/one week off. What is the acceptable pay rate? I've been doing this for something I am no longer to live on. Been doing this for 2 years. What do other people make? I get $10 beeper rate, then perhaps visit rate

Depending on the market in your area you could find a better deal.

Some places try to get away with not paying much - if you do not get called out a lot you are definitely getting the short straw.

With 2 years of solid experience in hospice you should be able to find a better deal!

Some places offer salaried position for on call that actually pays OK and they pay in addition when you have to drive out. Look for a different place to work!

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Depends where you live, in the bay area in California per diem hospice nurses get at least ~$50/hr + mileage by IRS standards. I haven't worked on call but I heard it's like $5/hr

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