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

[Googlenurse, ASN, BSN, RN]

To me it's simple.

Anyone that wants to work in a hospital should get the BSN.

Even now in the midst of a a severe shortage, many hospitals still have "BSN preferred" on their job advertisements. 

An RN that wants to work in non acute care doesn't need a BSN . That may change in the future though, as the local VNA in my area only wants BSN educated nurses. 

[Candi Williams]

2BS Nurse said:

I agree with Hobe: "What would make better nurses? Other nurse could mold better nurses by giving better training. Hospitals should be advocating for better training". These days, new nurses have to seek out training on their own time.

I'm my more limited experienced, it's the nurse who actually gives a sh*% about providing good care who makes the best nurse. I've worked with many who just don't care, BSN or not.

Moving into the education or supervisor fields don't always = better pay. Once salaried, you're putting in many unpaid hours. In my area, BSN and ADN are paid the same. You're not offered a salary increase upon BSN completion.

BSN and ADN are paid the same in my area also. Personally I think ADN nurses are just as skilled as BSN nurses when it comes to bedside nursing. I've worked with nurses and didn't know whether they had a BSN or ADN unless they told me and I know many ADN nurses who are better nurses than their BSN coworker. I agree with you, sometimes it comes down to whether or not the nurse cares. I've worked with some BSNs who felt entitled because of their BSN title. They showed more pride in the title than pride in actually being a good & competent nurse. I recently obtained my BSN and I do not feel it improved my nursing skills. I obtained it because I went into management otherwise I probably wouldn't have pursued one.

[Googlenurse, ASN, BSN, RN]

Gone are the days that you only got a BSN to work in management.
These days, you need a BSN to actually work bedside. Hence the BSN preferred for med surg hospital jobs. 

[Candi Williams]

Yes most hospitals prefer BSN and some require it. I was just stating why I decided to get mine. If hospitals paid nurses more for a BSN, I'm sure more ADN would go back to college. Although I think nursing us a calling, college is expensive. Money matters and people are not going to invest money they don't have if they aren't going to see an increase in pay.

[londonflo]

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.

When everyone does not to work fulltime, there are scholarships, contracts  that may the institution back by working 2 years for 2 years of scholarships provided, 

Every hospital I have worked at have some benefit to enriching  nursing/medical scholarships. Here is what I have found (overwhelming) the applicants need to write an essay. ( got pushback from my  daughter and son on this.)  

 

[Snatchedwig, BSN, CNA, LPN, RN]

No. Same thing that LPN's getting "phased out". With the pandemic, I've seen no difference in hiring practices of LPN's or ADNs.

 

And while we are on the topic. Clinically I learned absolutely nothing in the BSN program. It's a silly pointless research degree.

[londonflo]

Snatchedwig said:

Clinically I learned absolutely nothing in the BSN program. It's a silly pointless research degree.

Research is mainly focused on clinical. It is not silly or pointless.  The education was intended  for interpretation by you  to  provide better outcomes in your practice.   Someday when you move to a another  position you will find you were grounded in using research to better your practice, meet the needs of your new job and  contribute to bettering your patients lives.  

 

[MaxAttack, BSN, RN]

I've always hated this argument. There's a million confounding factors and it as long as we have evidence that short staffing is even more dangerous for patient care and safety it just seems like we're shooting ourselves in the foot. 

It sounds a lot like saying a patient admitted to the ICU has an increased risk of mortality so we should we phase out critical care.

I don't feel like I'm some god floating through the halls of my hospital because I learned community health nursing and APA formatting. 

[Snatchedwig, BSN, CNA, LPN, RN]

londonflo said:

Research is mainly focused on clinical. It is not silly or pointless.  The education was intended  for interpretation by you  to  provide better outcomes in your practice.   Someday when you move to a another  position you will find you were grounded in using research to better your practice, meet the needs of your new job and  contribute to bettering your patients lives.  

 

As I said its a silly pointless degree. You did all this 'advanced' research at the associates level.  If you didn't, you didn't pay attention.

[londonflo]

MaxAttack said:

I don't feel like I'm some god floating through the halls of my hospital because I learned community health nursing and APA formatting. 

I only spoke about the research education. But while you brought up community health nursing, have you considered what a patient needs in the home after an ICU or, for that matter, any discharge home with regards to assistive devices? I thought not. 

[FiremedicMike, RN, EMT-P]

londonflo said:

I only spoke about the research education. But while you brought up community health nursing, have you considered what a patient needs in the home after an ICU or, for that matter, any discharge home with regards to assistive devices? I thought not. 

I would have, because we talked about all that long term planning *** during our initial RN education.

 

 

[londonflo]

Snatchedwig said:

As I said its a silly pointless degree. You did all this 'advanced' research at the associates level.  If you didn't, you didn't pay attention.

I don't see a BSN designation after your name. What do you consider 'advanced' research at the associates level?