"To BSN or Not to BSN That is the question." Should BSN be minimal requirement?

Students ADN/BSN

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  • Specializes in Med-Surg, OB, ICU, Public Health Nursing.

You are reading page 3 of "To BSN or Not to BSN That is the question." Should BSN be minimal requirement?

Farawyn

12,646 Posts

OP, are you able to provide any information on any pending legislation in any state? That would meet my definition of "actively pursuing".

Yes. Everyone is *told* BSN. I'm in NY and I've heard "BSN in 5" for the last few years. Now working 2 jobs and turned down 2 more- not ONE mention of my non existent BSN, which I am halfheartedly pursuing.

roser13, ASN, RN

6,504 Posts

Specializes in Med/Surg, Ortho, ASC.

Again, "trends," "discussions" and anecdotes do not in any way support your original assertion that some states are considering taking action on this issue. Can you provide information that validates your original post?

Farawyn

12,646 Posts

I met with nurses from all over the US. The nurses particualarly in New York were most concerned about this issue. If readers don't want to believe that boards are not following this issue closely, that is their choice. However, when IOM, Robert Johnson Wood, magnet hospital folks are making statements/recommendations about the future of nursing, I tend to believe that boards are discussing and planning. I do not know specific pending legislation, however, if hospitals are hiring or declining applicants based on whether or not a nurse has a BSN, perhaps the day has already come.

My personal belief? Scare tactics. 2 years ago I was locked into a job I hated because I couldn't buy a job change without my BSN, now the offers are flooding in.

It's coming back around.

My thoughts? Same as most. Minimal BSN, grandfather in RNs and LPNs.

roser13, ASN, RN

6,504 Posts

Specializes in Med/Surg, Ortho, ASC.
I met with nurses from all over the US. The nurses particualarly in New York were most concerned about this issue. If readers don't want to believe that boards are not following this issue closely, that is their choice. However, when IOM, Robert Johnson Wood, magnet hospital folks are making statements/recommendations about the future of nursing, I tend to believe that boards are discussing and planning. I do not know specific pending legislation, however, if hospitals are hiring or declining applicants based on whether or not a nurse has a BSN, perhaps the day has already come.

I think that you are perhaps a little naive. Boards may well be "following this issue closely" but as you can see from our comments, they have supposedly been doing that for decades. There really is nothing new or newsworthy here without evidence to support the original post.

With such a surfeit of nurse applicants, why wouldn't hospitals choose to hire only those with the highest level of education? After all, they pay little to nothing more to the BSN than the ASN. That trend is simply hospitals doing what hospitals do best: hire the best they can for the least amount of money. IF/when an actual nursing shortage does occur due to boomer patients, watch how quickly the BSN requirement disappears as hospitals scramble to find nurses.

nurseactivist

247 Posts

Specializes in Med-Surg, OB, ICU, Public Health Nursing.

I guess then we hide our heads in the sand, don't discuss the possibility of it and scream and yell if it happens...

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Rose_Queen, BSN, MSN, RN

6 Articles; 11,663 Posts

Specializes in OR, Nursing Professional Development.
I guess then we hide our heads in the sand, don't discuss the possibility of it and scream and yell if it happens...

Or, be realistic in that these discussions have been happening for decades, and of those states who tried to initiate BSN entry into practice, they repealed those laws shortly thereafter (I believe one was North Dakota, but could be wrong about that).

Agencies can make all of the recommendations they want, employers can require BSNs all they want, but realistically passing a law to require it for licensure isn't likely. I'll get concerned when a bill is proposed in my state and actually makes it beyond the first step. Legislatures are too busy pandering to those interests that line their pockets; who would be lining their pockets in requiring BSN for licensure?

Altra, BSN, RN

6,255 Posts

Specializes in Emergency & Trauma/Adult ICU.

I agree that boards of nursing are "following the issue closely". And it may well be the case that this is a hot topic of discussion among NY nurses.

Neither of those = state legislators enacting legislation mandating new requirements for RN licensure in any state. Discussion topics in academic and professional circles cycle through fads, no different than pop culture. You can see this cycle (or is it short attention span ;) ) in the professional literature of other fields as well ... one year every journal article is about X, but by a couple of years later, the appetite for X has morphed into concern over Y.

As you have no doubt learned through your thorough research on the topic, exactly one US state, North Dakota, passed legislation mandating a BSN for licensure as a registered nurse. The effort lasted only a few years, before being considered to be so unworkable that the legislation was rescinded. If there are other states which believe they have worked out details to avoid the pitfalls of the ND experience and have pending bills scheduled for a legislative vote, or at least have had bills introduced into committee -- that would certainly indicate a state's intent to proceed, since it is the state which licenses nurses, not professional or academic associations of nurses.

Your note that employers in some geographic areas have expressed a strong preference for bachelors-prepared nurses is a different topic, and is a fascinating case study of free market demands vs. governmental regulation.

roser13, ASN, RN

6,504 Posts

Specializes in Med/Surg, Ortho, ASC.
I guess then we hide our heads in the sand, don't discuss the possibility of it and scream and yell if it happens...

Honey, it's been discussed, discussed, & discussed again. Over & over. And then some. Just do a search here. The discussions likely go back to the beginning of AN.com. Most of us just aren't interested in the same discussion, year after year. Your original post appeared to offer new information, but it now seems as if that was an illusion.

Altra, BSN, RN

6,255 Posts

Specializes in Emergency & Trauma/Adult ICU.

To be fair ... sometimes legislation which shakes up the status quo does indeed take decades. The wheels of change turn slowly. So if this is something you believe in, OP, make sure you are politically active. You can start with the political activities of whatever professional nursing associations in which you have membership to maintain contact with state legislators, or you could start directly with elected state representatives.

And for the record ... I, Altra, proud diploma graduate, favor BSN as a uniform educational path to RN licensure. I would like to see enactment of an 8 - 10-year transition period, with automatic grandfathering of all RNs licensed in the state at the time of the transition, regardless of degree.

MunoRN, RN

8,058 Posts

Specializes in Critical Care.

As far as I'm aware, NY has abandoned it's plans for BSN in 10, like many states have before them, and the only state to actually make the switch reversed their decision shortly after.

I can't speak for other states, but why my state chose against BSN as ETP is discussed here: https://allnurses.com/registered-nurses-diploma/bsn-as-entry-797956.html

The "short" answer is that there is no evidence to show that current graduates of non-BSN programs provide care that is statistically different than BSN prepared RNs. There were a number of studies that showed non-BSN programs, mainly in the 70's and 80's and early 90's, graduated nurses whose patients overall had poorer outcomes than BSN prepared nurses. When looking at these studies it's important to keep in mind that based on the data-collection period and the median graduation date for the nurses being studied, what was really being evaluated was ADN and diploma programs from the 70's to early 90's. Since then and largely in response to these studies these programs have changed drastically and now much more closely mirror BSN curriculum, in many cases using identical curriculum. All this evidence reliably establishes is that programs that have not evolved since that time period should either close or adopt BSN-comparable curriculum and requirements. So the first problem is that the need for BSN-only nurses is not currently well established.

Weighing against that lack of current evidence is that there are significant negative impacts to shuttering all non-BSN programs. The primary one being it's effect on clinical experience, which would likely worsen drastically. BSN program clinical opportunities are already often saturated, if not over-saturated. Concentrating nursing students to BSN programs would likely worsen, not improve, overall nursing education, particularly given the current shift to concurrent clinical and didactic experience, which requires more clinical availability per student, not less.

BSN-in-10 would solve the problem of clinical opportunities by spreading out all initial education, but it still has the same lack of evidence problem as entry-to-practice. The biggest drawback is that the nursing profession already has a problem with an extremely short career span, which BSN-in-10 would exacerbate. Ideally the number of expert nurses in the field would be similar to the number of novice nurses, but that already isn't the case. Some reports put the average career span of a nurse at about 8 years. Due to the typical demographics of a nurse between graduation and 10 years post graduation, a significant number of nurses would have no choice but to leave nursing if required to obtain an ADN-to-BSN, many of which likely would have continued on longer-than-average careers, which isn't something we want to discourage in any way.

Specializes in Cardiology.

I think it really is going to depend on the hospital, not necessarily the state. Before I started traveling my home hospital was starting to make a BSN mandatory because they are going for magnet status and a BSN makes us nurses look more "marketable" and also helps you climb the clinical ladder during your time of employment. They were giving all nurses that were hired in the last 5 years I think either 3 or 5 years to get their BSN or else they were getting canned. Seasoned nurses were in the clear. I went ahead and finished my BSN because it does make you appear more marketable when finding a job. I don't think there's enough support to make this mandatory everywhere, I find it's only going to be in a number of hospitals.

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nursel56

7,078 Posts

Specializes in Peds/outpatient FP,derm,allergy/private duty.
I met with nurses from all over the US. The nurses particualarly in New York were most concerned about this issue. If readers don't want to believe that boards are not following this issue closely, that is their choice. However, when IOM, Robert Johnson Wood, magnet hospital folks are making statements/recommendations about the future of nursing, I tend to believe that boards are discussing and planning. I do not know specific pending legislation, however, if hospitals are hiring or declining applicants based on whether or not a nurse has a BSN, perhaps the day has already come.

That would be my point. As of now, the marketplace is doing what a 50-year campaign could not do. In terms of serious issues that affect all nurses, here's a recent thread that touches on an issue we hear almost nothing about beyond our job environment. It has 524 replies, and yet the "fight back" part is not happening.

Hospitals Firing Seasoned Nurses: Nurses FIGHT Back!

If you're interested in an analysis of why "boards of nursing discussing this" didn't translate into actual legislation, here is an article that I found really informative. I'd also hope the IOM and the RWJ Foundation would now channel money and effort into making it possible for current associate-degree program students to easily continue their studies so they can be competitive in the job market with a BSN.

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