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

[KalipsoRed21, BSN, RN]

Haha, "they" have said that since I started in 2008. I spent 24K more to go ahead and get my BSN than my friend who got an ADN. We have made, on average, the same amount of money, hospital or elsewhere, since we started. Only difference has been a few jobs are more available to me than her. But she has been a director of a nursing home, travel nursed, everything I have with less debt. 
we both hate healthcare because it is NOTHING we learned it to be in school. It is basically getting paid to be abused and a scapegoat. 
But get your ADN, your BSN will still be there if you want it later.

[subee, MSN, CRNA]

KalipsoRed21 said:

Haha, "they" have said that since I started in 2008. I spent 24K more to go ahead and get my BSN than my friend who got an ADN. We have made, on average, the same amount of money, hospital or elsewhere, since we started. Only difference has been a few jobs are more available to me than her. But she has been a director of a nursing home, travel nursed, everything I have with less debt. 
we both hate healthcare because it is NOTHING we learned it to be in school. It is basically getting paid to be abused and a scapegoat. 
But get your ADN, your BSN will still be there if you want it later.

I wouldn't discourage anyone who could afford to go to a direct entry program for a BSN not to do that.  There are markets where your mobility would be limited without it.  I already had a BA before starting a BSN part time.  It took 3 years but I was able to graduate with minimal loans because I could work.  IMHO these 4 year programs offer use in getting the job you want .  I'm sorry you hate working in healthcare.  You sound bitter and I hope you can find something more suitable for you.

[Tommy5677]

subee said:

I wouldn't discourage anyone who could afford to go to a direct entry program for a BSN not to do that.

I would probably agree with this but in a different way. I would encourage people to get the ADN, take the NCLEX, get a job, and then enroll in a RN-BSN program. It's likely that in the long run it will cost less money. The only deterrent I can see to this is that those programs will tell you things like you can do it in 3 semesters, except we're talking about 60 credits. You're probably not going to do that in 3 semesters but at least you can work.

[Alexandra Champagne Taylor]

Phasing out ADN? I doubt it, we just coming out of a pandemic, and there is still a surg of COVID this fall. In addition, there is going to be a huge nursing shortage in 2030, when lots of nurses will be retiring. Furthermore colleges are making so much money with the RN/BSN, ADN  programs.. 

[subee, MSN, CRNA]

Alexandra Champagne Taylor said:

Phasing out ADN? I doubt it, we just coming out of a pandemic, and there is still a surg of COVID this fall. In addition, there is going to be a huge nursing shortage in 2030, when lots of nurses will be retiring. Furthermore colleges are making so much money with the RN/BSN, ADN  programs.. 

We have too many colleges now.  They are actually competing for the opportunity to charge students for a sub par education.    Why wait until 2030 for a nursing shortage?  It's here now due to the lack of attractive jobs, not that we don't have enough nurses.  

[londonflo]

Alexandra Champagne Taylor said:

. Furthermore colleges are making so much money with the RN/BSN, ADN  programs.. 

An ADN program is very expensive to run. In my state, we are limited to 10 students to a clinical instructor. What those 10 students pay in tuition for the clinical credit (3 hours of clinical equals 1 credit) does not pay the salary of the instructor. 

[toomuchbaloney]

londonflo said:

An ADN program is very expensive to run. In my state, we are limited to 10 students to a clinical instructor. What those 10 students pay in tuition for the clinical credit (3 hours of clinical equals 1 credit) does not pay the salary of the instructor. 

The government should support the education of the populace. 

[londonflo]

toomuchbaloney said:

The government should support the education of the populace. 

The government is doing this for many people.. look at your property tax bill - you will have a line item for taxes that go to your local community college district. While it  is "our money" that is taken by taxation, it does decrease the tuition rate for those students attending. Also, our Federal government does provide 'financial aide awards' to many. But TMB since "WE are the government" think about establishing your own scholarship for worthy students at a school near and dear to your heart. 

Tommy5677 said:

I would encourage people to get the ADN, take the NCLEX, get a job, and then enroll in a RN-BSN program.

And by then those completing the BSN program will have children and spousal obligations, tax bills, children's school costs..... all that and complain about working full time while going to school. I have heard it for years!!

Tommy5677 said:

The only deterrent I can see to this is that those programs will tell you things like you can do it in 3 semesters, except we're talking about 60 credits. You're probably not going to do that in 3 semesters but at least you can work.

Ahhh work....

KalipsoRed21 said:

But get your ADN, your BSN will still be there if you want it later.

And it will be there when you have child care, house work and house payments on your mind.

 

I 

 

[toomuchbaloney]

londonflo said:

The government is doing this for many people.. look at your property tax bill - you will have a line item for taxes that go to your local community college district. While it  is "our money" that is taken by taxation, it does decrease the tuition rate for those students attending. Also, our Federal government does provide 'financial aide awards' to many. But TMB since "WE are the government" think about establishing your own scholarship for worthy students at a school near and dear to your heart. 

And by then those completing the BSN program will have children and spousal obligations, tax bills, children's school costs..... all that and complain about working full time while going to school. I have heard it for years!!

Ahhh work....

And it will be there when you have child care, house work and house payments on your mind.

 

I 

 

Since WE are the government, why should I, or anyone else need to personally create a scholarship? We the People should fund public education well enough that low income students don't need a privately funded scholarship to attend a public college any more than they need scholarships for their high school education.  IMV

[londonflo]

toomuchbaloney said:

We the People should fund public education well enough that low income students don't need a privately funded scholarship to attend a public college any more than they need scholarships for their high school education. 

Low income students are eligible for many any government-paid programs to get educated in well-paying trade professions ( some with a living stipend) at many community colleges. Our city has billboards up informing our citizens of this educational program - full tuition plus stipend for living. 

https://www.illinoiswei.org/

This second one has been around for at least a decade. I am not sure about specific personal funding the student gets, but it is a very supportive program. 

https://www2.ED.gov/about/offices/list/ope/trio/index.html

 

[toomuchbaloney]

londonflo said:

Low income students are eligible for many any government-paid programs to get educated in well-paying trade professions ( some with a living stipend) at many community colleges. Our city has billboards up informing our citizens of this educational program - full tuition plus stipend for living. 

https://www.illinoiswei.org/

This second one has been around for at least a decade. I am not sure about specific personal funding the student gets, but it is a very supportive program. 

https://www2.ED.gov/about/offices/list/ope/trio/index.html

 

These programs are great.  They should be wide spread and easy to access.  We should invest in our people and our infrastructure.  

[subee, MSN, CRNA]

toomuchbaloney said:

These programs are great.  They should be wide spread and easy to access.  We should invest in our people and our infrastructure.  

Gosh, remember when that was one of the missions of governance?