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

[Hannahbanana, BSN, MSN]

Tommy5677 said:

With regards to better patient outcomes with BSN's, if the University of Penn has a BSN program with associated hospitals, that is not objective, independent research. Please try again.

I don't suppose that you read the poster's initial question, which was seeking current studies using data collection from hospitals with all kinds of nurses employed side-by-side, or the data from this study from many different hospitals, not just the UPenn hospitals. 

It's a disingenuous fallacy to assert (or imply) that because a research study is performed by a unit of a university (I'll let you read it and see which one... it's not the college of nursing) that therefore they are biased a priori about their subjects. That's like saying that because the Red Cross and the American Heart Association teach CPR they shouldn't be interested in out-of-hospital cardiac arrest recognition, treatment, and outcomes.  
 

Who, or what entity, specifically, do you have in mind for conducting "independent research" on nursing actions and outcomes? The AFL-CIO? NASA? The Chamber of Commerce? Maybe the ANA should conduct safety research on railroads or mining, then? 

[londonflo]

Googlenurse said:

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.

The vultures (for profit and non profit schools)  know we are (infighting) on this educational degree and  they are taking full advantage of it. The BSN completion programs tout any thing to make sure the ADN RN  is  guaranteed  they can work full time while taking  the BSN courses which are only a 'bleep' in the student's life. 

[Wuzzie]

londonflo said:

The BSN completion programs tout any thing to make sure the ADN RN  is  guaranteed  they can work full time while taking  the BSN courses which are only a 'bleep' in the student's life

Can you please clarify what point you are making here because I'm not sure I like what you are implying. 

[londonflo]

Wuzzie said:

Can you please clarify what point you are making here

I am not implying, I am actually saying.. All the ADN students look for programs where they can work fulltime while completing their BSN. (Let's face it, the hospitals that pay for the program require this.)

The BSN completion programs themselves do NOT say you can work fulltime  but do not state otherwise. 

The same happens with NP programs like Walden etc. Prospective students look for programs where they can work full time---which lead to the proliferation of  poor  easy to access online programs with no hands on teaching. 

Statements from students looking to work fulltime while completing ADN to RN and RN to NP are repeated in many threads here. 

What happened to immersing yourself in your studies, when developing your papers physically going to the  medical library, searching through the stacks, maybe going to another health care library to really develop your thesis question?  NO we have students complaining the college resource accessible nursing research articles on line are out dated...never to take any initiative to  investigate  in their own hospital's medical library  (where a Health Science Librarian would help them become a true researcher)!!

I got carried away here but I hate current online BSN, NP and DNP programs with a passion. They are a wart on the face of nursing education. 

 

 

[londonflo]

Hannahbanana said:

Not sure what you meant by counting credits in this way, because not all colleges count them the same.

ACEN and CCNE, including Regional colleges count all courses as:

1 hour week of didactic= 1 credit

2 hours of lab science/nursing science = 1 credit

3  hours of clinical practicum = 1 credit

each hour of class (didactic) =1 credit

 3 hours of class equals = 3 credits. 

Since you say you are a nursing consultant, I thought you would know this. 

[Wuzzie]

londonflo said:

What happened to immersing yourself in your studies, when developing your papers physically going to the  medical library, searching through the stacks, maybe going to another health care library to really develop your thesis question? 

 

londonflo said:

I got carried away here but I hate current online BSN, NP and DNP programs with a passion. They are a wart on the face of nursing education. 

So you'd rather someone NOT continue their education at all because they can't afford to not work fulltime? Education is what you make of it. Plenty of people skate through formal BSN programs. I work with some of them. 

I blocked you before because of your attitude and only recently unblocked you. I can see I made a mistake by doing that. 

[FiremedicMike, RN, EMT-P]

Wuzzie said:

So you'd rather someone NOT continue their education at all because they can't afford to not work fulltime? Education is what you make of it. Plenty of people skate through formal BSN programs. I work with some of them. 

I blocked you before because of your attitude and only recently unblocked you. I can see I made a mistake by doing that. 

You're missing their point which has been made over and over again - most RN to BSN programs are complete fluff, designed to be as easy as possible, advertised and known to be easy to complete even while working full time and picking up bonus shifts.  They offer nothing to clinical practice, but by God that piece of paper is so very important.

[Wuzzie]

FiremedicMike said:

You're missing their point which has been made over and over again - most RN to BSN programs are complete fluff, designed to be as easy as possible, advertised and known to be easy to complete even while working full time and picking up bonus shifts.  They offer nothing to clinical practice, but by God that piece of paper is so very important.

So what is your suggestion for a person working full time who wants to get their BSN? You missed my point. Education is what the individual makes of it. 

[FiremedicMike, RN, EMT-P]

Wuzzie said:

So what is your suggestion for a person working full time who wants to get their BSN? You missed my point. Education is what the individual makes of it. 

There's no reality where a discussion board once per week and a paper once per class can be made into quality education.

You acknowledge that traditional BSN programs can be useless, thousands of experienced nurses post here that most RN to BSN programs are fairly useless, but continue to insist that piece of paper is critical.

Y'all want the BSN to become an actual critical component of nursing care, then make it more than discussion boards and PICOTs.

 

 

[Wuzzie]

FiremedicMike said:

There's no reality where a discussion board once per week and a paper once per class can be made into quality education.

You acknowledge that traditional BSN programs can be useless, thousands of experienced nurses post here that most RN to BSN programs are fairly useless, but continue to insist that piece of paper is critical.

Y'all want the BSN to become an actual critical component of nursing care, then make it more than discussion boards and PICOTs.

 

 

I don't disagree with you at all but if a BSN is going to be required how in the hell is someone with a full time job and kids and a house and bills supposed to get one if not on-line? That was my beef with the previous poster and why I asked for clarification. Apparently she feels that anything less than full time study is a "wart on the face of nursing education". It's degree inflation at it's worse. First Diploma and ADN nurses need a BSNs because they suck and make patients die. So when they try to get that education in a way that works for them now that education sucks. Nothing is ever good enough. It seems to me all they want to do is get rid of them entirely like they are somehow...less than. 

FTR: I have many friends in respected brick and mortar schools for their NP. You know what their education consists of? Writing papers, weekly discussion groups and having to find their own preceptors. 

[Ann Fosque]

Very Nice...

Time will tell...we all have opinions...hopefully I am allowed to express mine

Too bad Team Nursing is not an option...Team nursing is a system that distributes the care of a patient amongst a team that is all working together to provide for this person. This team consists of up to 4 to 6 members that has a team leader who gives jobs and instructions to the group...

Perhaps it could be a stop-gap measure used until hospitals recover financially post COVID-19 

[Hannahbanana, BSN, MSN]

londonflo said:

1 hour week of didactic= 1 credit

 2 hours of lab science/nursing science = 1 credit

3  hours of clinical practicum = 1 credit

each hour of class (didactic) =1 credit

 3 hours of class equals = 3 credits. 

Since you say you are a nursing consultant, I thought you would know this. 

I am flattered that you think I know everything there is to know about the current methods of counting credits. I have worked as a legal nurse consultant but have never held myself out as a testifying expert on curriculum design or accreditation other than the more general. I look more at outcomes.

I'm still not sure what your point was Re my undergraduate credits anyway, but hey.

As to the question (which may not have been yours) about how is somebody supposed to spend the time and money for an entry-level four year degree, you may ask the same of anyone who wants to be a teacher, an architect, premed or prelaw, law enforcement, social worker, or any of a bazillion other professions. Why do they need bachelor's degrees, anyway? Historically, heck, John Adams didn't go to law school, and Florence didn't have a uni degree, so ... and so on. Piffle. 
I believe that as a profession we need to:

* advocate and press for financial subsidies for students, faculties, and facilities from government, foundations, and industry

* do a damn sight better job in convincing young people and guidance counselors that nursing IS a profession requiring a professional degree when they're thinking about college (have you advocated for nursing that way?)

* keep beating the drum with journalism to get them to quote nurses as experts and publish our credentials the same way they reflexively append "MD" and others when we write a letter to the editor or a "My View" column in the local paper... and we need to write them!

* call employers out on the need to pay nurses like professionals and provide professional working conditions for them 

We're never going to be able to do much of that as long as we keep saying things like, "I don't need a better education to be a nurse,” "I know a degreed nurse who can't tell you how to implement a bedpan,” or "my crusty old LPN is a better bedside nurse than a new BSN.” Even if these anecdotes may be true for some individuals, they're not representative of an entire profession and certainly not what we should be advocating if we want the respect due a professional. Or be sick enough in the hospital to need informed care.