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

[PizzaNurse2023, LPN]

Hire more LPNs. That's the solution. We can do almost everything. Except create care plans, push some thrombolytic IV meds, can't do initial education, and few other small task can't do.

[floydnightingale]

Don Gloves said:

 

Not long after I started working they took on a new grad from a prestigious state university (that description might narrow it down, how may state schools are prestigious?) but he was in over his head and it wasn't long before he quit and went to law school. Those who can, do, and those who can't sue.

My own alma mater was an urban third tier university but was ranked high for nursing, like top low 20s in US News, only surpassed in the state by the prestigious school that churned out the future attorney.

[mrphil79]

No way - they've been pushing BSN forever. 
They somewhat successfully got rid of a ton of LPN/LVN options and hospitals nationwide stopped hiring them or required them to get their RN... But so many hospitals now are bringing back LPNs because they simply need the staff. 

[toomuchbaloney]

mrphil79 said:

No way - they've been pushing BSN forever. 
They somewhat successfully got rid of a ton of LPN/LVN options and hospitals nationwide stopped hiring them or required them to get their RN... But so many hospitals now are bringing back LPNs because they simply need the staff. 

The long term, capitalist staffing models have come back to bite the employers in the orifice.

[mel21]

I have found that and nurses are just as good as Ben nurses, sometimes better, it is more the nurse than the degree. 

mel21 said:

I have found that ADN nurses are just as good as BSN nurses, sometimes better, it is more the nurse than the degree. Auto correct corrected!

[Jake Jennings]

Nursing is already a terrible job for which most people don't want to go into at all. Making the "bare minimum standards" for entry into the profession is absolutely not going to improve staffing shortages anytime soon. Another issue with the profession is keeping people at the bedside. Nobody wants to spend $100k or more on student loans (which they'll have to pay back) to go into a thankless profession where every single day you go to work your license, and your future livelihood, are constantly at stake because the Hospital Administrators wanted to understaff the place to keep from having to pay people for quality work just so they can toot their own horns and get their fat quarterly bonuses that none of the nurses (who actually do all the ***ing work) don't get. *** around and find out what's gonna happen when you set the bar for entry so high that nobody in their right mind wants to consider the profession at all, and the ones who did get burned the *** out and walk the *** out the door leaving you even more short handed! Here's an idea! Pay people what they're worth! Don't overwork your staff to the point of pulling their own hair out on any given day or night, staff your units appropriately, and bring back hospital diploma programs so that more people can get into the job to begin with... with supply increasing, the demand will go down! If you have an abundance of qualified staff to do the job, you can pay them less! Additionally, stop wasting money hiring temporary travel staff and just pay better! You would save a *** of money if you just paid your loyal staff better!

[Ann Fosque]

I believe there is room in Healthcare for very level of Nursing.

I personally know a LPN, who became a RN and is now an APN with her PHD.

She is works as a Curriculum Administrator.

Not every patient or Unit needs a BSN RN at the bedside. 

 

 

[toomuchbaloney]

Ann Fosque said:

I believe there is room in Healthcare for very level of Nursing.

I personally know a LPN, who became a RN and is now an APN with her PHD.

She is works as a Curriculum Administrator.

Not every patient or Unit needs a BSN RN at the bedside. 

 

 

The fact that a BSN is not necessary to achieve nursing goals in most patient care settings was nicely established by decades of practice by diploma and AD prepared registered nurses.  

How has the quality of the U.S. healthcare system changed over time?

The only thing that requiring bedside nurses to have BSN educations achieved was made up prestige for the facilities, barriers to employment for capable nurses, and unnecessary debt for nurses who are historically underpaid for their expertise.  The data reflects that. It certainly hasn't changed the trajectory of the healthcare that the employers of nurses are supposed to be providing for the better.  

[FiremedicMike, RN, EMT-P]

Working on a whopping 3 page paper today to analyze any bill related to nursing.  Must include APA formatting, title page, headers, and a whopping -6- "scholarly references".

As has been the objective thus far, the content really doesn't matter, lets just make sure you can write a paper..

I'm sure my patients tomorrow will notice a difference in the level of care I provide thanks to this.

I'm convinced the instructors of these classes are disconnected from reality.