Phasing Out ADN?

[Candi Williams]

Should We Hire ADNs? or Phase It Out?

The national nursing shortage has caused a crucial call for nurses. Nurses are a core part of the healthcare industry. They are the largest professional sector within the healthcare workforce and are essential to patient care. One solution to the nursing shortage is to hire Associate Degree in Nursing (ADN) graduates, but will the growing trend pushing for all nurses to have a Bachelor of Science in Nursing (BSN) for hire, phase out ADN programs? Let's bring to light the nursing shortage and the advantages and disadvantages of ADN and BSN degrees.

The growing trend in the healthcare industry pushing for all nurses to have a BSN degree for hire will not phase out ADN nurses anytime soon. The demand for nurses is too high. Approximately 40 percent of new nurse graduates earn their degrees from associate degree programs. An advantage of ADN programs is bringing new nurses into the workforce sooner. ADN programs prepare students to take the NCLEX-RN exam and become Registered Nurses (RN) in two to three years versus four-year BSN programs.

Why ADN?

ADN programs are more appealing to many because of the low cost and shorter time frame it takes to become a Registered Nurse; it grants them the opportunity to start working as a nurse sooner. Being introduced into the nursing workforce sooner affords them income as a nurse and a chance to gain experience while pursuing a BSN degree. In 2010 the Institute of Medicine (IOM), now the National Academy of Medicine, recommended that 80% of registered nurses earn a BSN degree by 2020. As a result, medical institutions prefer to hire nurses with a BSN degree or higher. Some institutions require a BSN degree for hire, and if they hire a nurse with an ADN, a condition of employment is earning a BSN degree within a certain length of time.

Why BSN Degree or Higher?

Better Pay

Nurses with BSN degrees have the possibility to generate higher income compared to those with ADN degrees. They can obtain positions offered to nurses who hold BSN degrees or higher. These positions come with more responsibilities and higher pay—positions such as managers, administrators, and educators.

Improve Patient Care

Research has shown that medical institutions that have a higher percentage of qualified BSN nurses on staff deliver quality patient care. They contribute to decreased medication errors, better patient outcomes, lower hospital-acquired infections, decreased mortality rates, and a decline in failure-to-rescue rates.

Magnet Certification

Healthcare organizations have begun seeking nurses with higher education and aspire to Magnet Certification. A major requirement for earning certification is the educational level of the nurses on staff. The higher the percentage of nursing staff with a BSN or greater, the better their chances are of Magnet certification. Magnet Certification yields outstanding nursing processes with notable quality, safety, and patient satisfaction.

Ramifications of Nursing Shortage

Discussions about concerns over the nursing shortage were taking place prior to the Covid-19 Pandemic. The Bureau of Labor Statistics predicted a shortage of over one million registered nurses by the year 2022. Cutbacks in nursing are attributed to one of the reasons for the shortage. Nurses fall victim to reductions in labor costs because they make up the largest labor force in the healthcare industry. Those reductions are decremental to the safety of patients and nurses. Another cause for the shortage is not enough educators. Nursing programs routinely turn down applicants because they have a limited number of nursing educators to train them. Other causes for the shortage are nurse burnout, an increase in the aging population, and an aging workforce.

Covid-19 escalated the nursing shortage. Covid caused an increase in patient volume, a rise in nurse burnout, early retirement from nurses who were close to retirement, and nurses leaving the profession altogether.

Nursing shortages give rise to medication errors, patient falls, increased morbidity, and increased mortality rates. When organizations lack appropriate staffing levels, the patient-to-nurse ratio is higher. This leads to nurse burnout and discontent. A suitable amount of nursing personnel reduces errors, increases patient safety, improves patient satisfaction, and enhances nurse retention.

Healthcare organizations, nurse leaders, and government officials must devise solutions to the nursing shortage. They must strive to engage and keep nurses. Retention of nurses brings about quality nursing care, improved patient care, and patient satisfaction.

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References/Resources

ADN vs BSN Debate: These Are the Real Differences Between ADN and BSN Prepared Nurses: Nightingale College

The Staffing Shortage Pandemic: Journal of Radiology Nursing

Are ADN & ASN Programs Needed to Meet the Nursing Shortages at Hospitals?: Advocate Search Group

Nursing Workforce Challenges in the Postpandemic World: National Library of Medicine

Nursing Fact Sheet: American Association of Colleges of Nursing (AACN)

Nursing educators: Stress the importance of a BSN in nursing, your students will thank you: Wolters Kluwer N.V.

Nursing Shortage: (Stat Pearls) National Library of Medicine

Reaching beyond 80% BSN-prepared nurses-One organization's journey to success: Nursing Management

[Hobe]

Our ADN had community nursing.

They also told us the C stiudents made  better nurses the A students were to by the book. LOL. 

[catdevil27]

Exactly, ADN's may not have as much classroom time as a BSN but nursing isn't just about book learning. Nursing, GOOD nusing is about critical thinking, common sense ( which is imho NOT all that common) neither of which can be taught. You either have  them or you don't. 

I have worked with some extraodinary nurses in my 30 year career, some BSN< some ADN's and some diploma nurses...NO DEGREE. I have also worked with nurses who frankly scared the crap out of me, but they went to school and passed the NCLEX....same...across the board, diploma type or possession the same. It boils down to the individual and the gifts God gave them. Not everyone can be a great nurse and thats OK.....I couldn't teach elementary school. I have the smarts, I don't have the right temperament.

If someone wants to tell non BSNs that they aren't valid I hope they are prepared when they longer have this LARGE and essential core group is GONE. **clue**they aren't.

 

Hobe said:

Our ADN had community nursing.

They also told us the C stiudents made  better nurses the A students were to by the book. LOL. 

LOL! I never heard that oen, and I certainly never used it when I was teaching nursing. Wow...that's interesting.

[Lust4life, BSN]

When I received my ASN it took about 4 years to accomplish from start of general academic courses (2 yrs) and by year 3 you were qualified to enter into the specific nursing course requirements. 

I learned what nursing is and how to be a great nurse in those years. I graduated, passed the NCLEX on the first attempt, and went right into trauma ICU. At that time, they loved new nurses in the ICU. What I learned in those years is no match for what I learned in the Accelerated RN-BSN courses. If I recall correctly, it took me 13 months to earn the BSN, and consisted of writing papers daily, if not every other day, to pass. I recall learning about nursing research and peer reviewed papers. They crammed years worth of information into 13 month and I paid nearly 30,000 for the degree. I learned new things but I was already at the bedside for 4 years before I became a BSN. 

My point I'm trying to poorly make here LOL, is that as a new ASN graduate, I was ready to be a good nurse. Being on the floors, assisted me in achieving the BSN. 

ADN on the floors is what nursing needs. The BSN is just a small cherry on top of a well made cake. I feel like I paid a lot of money to be a BSN, and have the initials, but in my ADN courses is what made me a nurse. 

[Lust4life, BSN]

catdevil27 said:

Exactly, ADN's may not have as much classroom time as a BSN but nursing isn't just about book learning. Nursing, GOOD nusing is about critical thinking, common sense ( which is imho NOT all that common) neither of which can be taught. You either have  them or you don't. 

I have worked with some extraodinary nurses in my 30 year career, some BSN< some ADN's and some diploma nurses...NO DEGREE. I have also worked with nurses who frankly scared the crap out of me, but they went to school and passed the NCLEX....same...across the board, diploma type or possession the same. It boils down to the individual and the gifts God gave them. Not everyone can be a great nurse and thats OK.....I couldn't teach elementary school. I have the smarts, I don't have the right temperament.

If someone wants to tell non BSNs that they aren't valid I hope they are prepared when they longer have this LARGE and essential core group is GONE. **clue**they aren't.

 

LOL! I never heard that oen, and I certainly never used it when I was teaching nursing. Wow...that's interesting.

What I heard in nursing school was that C = RN! LOL

That was encouraging, after many instructors said more than half of us wouldn't make it. 

Those instructors were correct. I don't think anyone made it through with less than a B average. It was a tough program, but solid. 

ASN = great hands on nurses.

BSN = great writers about nursing. The calm after the floor nursing storm?

[londonflo]

Lust4life said:

That was encouraging, after many instructors said more than half of us wouldn't make it. 

This such a bizarre comment. What college admits unqualified students so that only 50% graduate? Was this some crappy Florida school that accepted tuition from the first year of students, but didn't want them to graduate  and mess up their NCLEX passing rate??? You gotta help me here. No ADN program (outside of Florida)  could continue to get funding if they accepted qualified students and then failed them. 

And if your heard a faculty member said more than half of you wouldn't make it, I would attribute this to an urban legend. 

[Lust4life, BSN]

It was years ago. A 2 yr college. This was before they implemented TEAS testing, so there was no testing to get into the program. The comment was made by a couple instructors. I don't know the exact size of our class, but it was fairly large when we all began together. In the end, about half of us graduated with the degree. Those who didn't, either withdrew or didn't make the passing grade needed. 

That isn't as much of a concern today, because students must test into the program to be accepted. 

I believe the comment was in regard to student ability, not the program. The college didn't fail them, they did, or was unable to complete for other reasons. 

[Tommy5677]

londonflo said:

And if your heard a faculty member said more than half of you wouldn't make it, I would attribute this to an urban legend. 

43 Years ago I received my ASN from a private university. We started with 66 and graduated 32 so yes, there is a weeding out process. Also, when I did the ASN I did the entire thing in 2 years, including 2 semesters in the summers, which is kind of not a thing anymore.

[toomuchbaloney]

Tommy5677 said:

43 Years ago I received my ASN from a private university. We started with 66 and graduated 32 so yes, there is a weeding out process. Also, when I did the ASN I did the entire thing in 2 years, including 2 semesters in the summers, which is kind of not a thing anymore.

Things have changed... our experiences are similar. 

[Hoosier_RN, MSN]

Googlenurse said:

I don't know that I buy the argument a BSN is so much more unaffordable than Lpn and ADN programs.

I know Lpns that paid $54,000 to go to Lpn school through Lincoln Tech. 

I also know RN to BSN students that paid $25,000 for Chamberlains program. It was even more than that but my job had tuition reimbursement. So after tuition reimbursement it was $25,000.

I chose WGU because it was non profit and cheaper. My job didn't even have tuition reimbursement for WGU, but it still was cheaper than Chamberlain even with tuition reimbursement. Chamberlain is for profit. 

While I did state CC for my ASN, then IU for my  ASN-BSN, then WGU for MSN, it has to be noted that WGU is not available in all states. Not every area has this, or other lower cost options. 

[londonflo]

Tommy5677 said:

43 Years ago I received my ASN from a private university. We started with 66 and graduated 32 so yes, there is a weeding out process

I was a faculty member at a diploma school. We had a few drop or fail for dosage and calculation (when it was desired desired over hand) .  

[londonflo]

Hobe said:

They also told us the C stiudents made  better nurses the A students were to by the book. LOL. 

So it is not best to know a sound knowledge base  to answer a test question? Is the opposite to rather cut corners, not follow asepsis guidelines not really know how to answer the test question, get multiple wrong answers on a test?, You had a faculty member tell you were better than a nurse that had better grades? This is when the back stabbing starts. Leave the thought of this in the past of urban legends. The faculty member is just trying to make themselves feel better and by extension you. Dissing the book, book authors, book content shows such envy they felt that was impossible for them to achieve any thing like a published books. These malcontents will continue to sling anything that makes them feel better. 

This dissing of other nurses achievements is a hallmark of nursing jealousy. Someone writes a book --we hear "they can't practice but they will write tell us what the rest of us can do. 

Just personal insight, what I got my MSN my RN sister said "now you can write the books that tell us all what to do." She was not practicing then, but took a nursing refresher course. After clinicals  she called me every day with concerns if what she did was right. Her creepy MIL cornered me in the house and said I needed to take a refresher course! I said I teach the courses.....

[kbrn2002, ADN, RN]

Tommy5677 said:

43 Years ago I received my ASN from a private university. We started with 66 and graduated 32 so yes, there is a weeding out process. Also, when I did the ASN I did the entire thing in 2 years, including 2 semesters in the summers, which is kind of not a thing anymore.

Same experience 25 years ago here. Except it was the local community college.  The very first orientation session the program director said  "half of you won't graduate" as part of part of the welcome speech.  She wasn't wrong. Many dropped out on their own for various reasons, several failed a class and to my knowledge did not opt to come back the next year to repeat it.  There was only one student in our cohort that had failed out the first semester the previous year and started over. She passed and graduated with us this time around. My final semester there were another  two students who joined our graduating class that had failed that class the previous year and came back, both of them also passed the second time around and graduated with my class,