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

[Hoosier_RN, MSN]

FiremedicMike said:

Prove it.  And don't cite studies that say "hospitals with more BSN's have lower mortality rates" because that ignores a myriad of other confounding variables.

Frankly, it's academically dishonest to say otherwise.  There is literally no possible way to prove that a BSN is the variable that makes one nurse better than another.  The BSN simply cannot ever be isolated as an independent variable in any real meaningful way.  Work experience, life experience, unit staffing, unit management support, even whether or not they had a healthy breakfast that morning or were able to pee in the last hour can affect it.  And lets not forget, no two patients, no two patient outcomes, no two cardiac arrests are EVER the same.

I do want to be clear on one thing, I do enjoy education.  I have a bachelors in another field, now an ADN, currently working on a dual enrollment BSN/MSN program, so I enjoy learning, but I'm not going to sit around the campfire and try to convince everyone that a nurse becomes a better nurse just because they earned a BSN.

 

 

The studies that tout a BSN better than an ASN out of the gate were done by...drumroll...4 year universities that offer BSN programs. IMHO a nurse is made better by their experience, and that's where the difference lies

[toomuchbaloney]

BSN prepared nurses at the bedside has increased to roughly 70% of all nursing staff according to 2022 data.  Now look at the trends in patient outcomes and life expectancy and convince me that the BSN makes it more likely that the patient gets better or more professional care from the bedside nurse.  

[MrChicagoRN, RN]

They've been talking about this for decades. At one time licenses were rebranded, and all existing RN and new BSN would be REGISTERED PROFESSIONAL NURSE, while any new diploma or ADN grads would be simply RN. 

Law never passed, and that was back in the mid 80's.

[lifelearningrn, BSN, RN]

ADN schools vastly outnumber BSN programs. I just don't see it ever happening. Just like they've been trying to phase out LPN/LVNs. There is always a need for nurses at all education levels. 

[Tommy5677]

lifelearningrn said:

There is always a need for nurses at all education levels. 

But the unfortunate part is that the ADNs have been relegated to nursing homes. Not to take away from nursing homes but there should be more options. If you don't want ADNs in management, fine, but don't take away hospital bedside. The notion that BSN's are better nurses is a myth and remember, we all take the same exam. If you want ADNs to be less than, give them a different exam but don't make them take the same exam and call them less than. That's what the nursing profession is doing.

[subee, MSN, CRNA]

Tommy5677 said:

But the unfortunate part is that the ADNs have been relegated to nursing homes. Not to take away from nursing homes but there should be more options. If you don't want ADNs in management, fine, but don't take away hospital bedside. The notion that BSN's are better nurses is a myth and remember, we all take the same exam. If you want ADNs to be less than, give them a different exam but don't make them take the same exam and call them less than. That's what the nursing profession is doing.

I think that a lot of nurses are going to disagree with you about ADN's having a hard time get hospital jobs.  Have you personal knowledge that we are going to have two sets of boards?  Even if we did, ADN's would still be hired in hospitals.  My magnet hospital in town hires ADNs aplenty with the proviso that they must get a BSN within 5 years and they pay for it.  Not a bad deal at all.  I know that it's tougher for ADN's in a large metropolitan market but not in most of America.

[Jurse, LPN]

Tommy5677 said:

But the unfortunate part is that the ADNs have been relegated to nursing homes. Not to take away from nursing homes but there should be more options. If you don't want ADNs in management, fine, but don't take away hospital bedside. The notion that BSN's are better nurses is a myth and remember, we all take the same exam. If you want ADNs to be less than, give them a different exam but don't make them take the same exam and call them less than. That's what the nursing profession is doing.

I'm an LPN and working in the step-down unit in a hospital. I don't have any associations in that hospital. The only I had with them, was I trained with them during nursing school. I haven't complained about not getting enough hours. Anyway, I don't know where you're all located. If the ADNs, RNs, LPNs, and LVNs do not find a job, it means we don't have problems with staffing. Right now, my phone is bloating from messages to work so they wouldn't be short-staffed. 

 

[Jurse, LPN]

Tommy5677 said:

But the unfortunate part is that the ADNs have been relegated to nursing homes. Not to take away from nursing homes but there should be more options. If you don't want ADNs in management, fine, but don't take away hospital bedside. The notion that BSN's are better nurses is a myth and remember, we all take the same exam. If you want ADNs to be less than, give them a different exam but don't make them take the same exam and call them less than. That's what the nursing profession is doing.

RN is an RN where I live. 

[Shary Frank]

The national nursing shortage has prompted a critical need for more nurses. While one solution to address this shortage is to recruit Associate Degree in Nursing (ADN) graduates, there is a growing trend advocating for all nurses to hold a Bachelor of Science in Nursing (BSN). This trend raises the question of whether ADN programs will eventually be phased out.

[CrunchRN, ADN, RN]

Same as they have been saying for almost 30 years. 

[kbrn2002, ADN, RN]

Shary Frank said:

The national nursing shortage has prompted a critical need for more nurses. While one solution to address this shortage is to recruit Associate Degree in Nursing (ADN) graduates, there is a growing trend advocating for all nurses to hold a Bachelor of Science in Nursing (BSN). This trend raises the question of whether ADN programs will eventually be phased out.

Well never say never but this ADN V BSN  argument has been going on in this forum since I've been here and that's been a LOT of years.  ADN programs aren't going anywhere, at least not for the foreseeable future. 

[SuzanneRNLA]

Shary Frank said:

The national nursing shortage has prompted a critical need for more nurses. While one solution to address this shortage is to recruit Associate Degree in Nursing (ADN) graduates, there is a growing trend advocating for all nurses to hold a Bachelor of Science in Nursing (BSN). This trend raises the question of whether ADN programs will eventually be phased out.

I graduated with an ADN in 1977, and that was the message back then. And yet here we are, still hearing the same message. I have never had a problem getting a job I wanted. I've been a floor nurse, supervisor, manager, director, case manager, and Information systems RN. I do have a BA and MS in other fields, though.