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

[nurseactivist]

There are states in the eastern part of the US, who are actively debating whether to require a BSN as a minimal requirement to become an RN. If this becomes law, should currently licensed RNs be "grandfathered in?"

While I hold a BS in Nursing, I personally do not agree with mandating a change. I have seen nurses: the good, the bad, and the ugly who are diploma grads, 2 year college grads and 4+ year grads.

What do you think?

[ERGirl83]

As an ADN nurse, I do think we need a more streamlined educational pathway, and it makes sense that a bachelor's degree would become the entry point. But not under the current model of BSN instruction. I keep putting mine off because I know it will give me zero additional clinical skills and I have zero interest in a management position. Not to mention all the fly by night online programs that water down the meaning of the degree to begin with. If we are going to require a BSN level education as an entry point for practice, a revamping of the current system needs to happen. For starters, the entire 4 years need to consist of clinical hours and skills training. Personally, I would love to see didactic and clinical skills taught the first 3 years and have the 4th year function as a residency program in conjunction with local hospitals and facilities, similar to what MD's experience. Then, graduating RN's would already have experience in their chosen specialties, hospitals would have a pool of qualified applicants whose work ethic they have already vetted for open positions. To me, this is far more valuable that spending hours dissecting theories which (to me) are nothing more than someone else's opinion about what we are already doing, and are about as useful as nursing diagnoses.

Of course, none of this will actually happen because the establishment isn't interested in changing. Not to mention that it would be logistically difficult and would essentially put these fly by night 2 year, for profit colleges out of business and relegate nursing back to more traditional colleges and universities.

I guess I should also clarify that the RN-BSN programs around here have no clinical hours and are largely management and theory classes. The 4 year straight BSN programs are different altogether and preferable to splitting it given the current model, in my opinion. I shouldnt assume that all RN-BSN programs are the same.

[AutumnApple]

Rest assured, if they do decide to make BSN the minimum requirement (or not) the decision will be based solely on profit and political favors. What is good for Nursing as a profession, patient safety and the community will play a part in the decision making process but not enough of a part to influence the final decision.

As someone said on the first page of this thread: "I'm wondering what states are debating this." I don't know the answer to that myself. While hospitals are requiring BSN's more and more, truth is, many of them give heavy "exceptions" when hiring becomes a need. The online application site says BSN required, but it's usually a whole different story. I just recently returned to nursing after a seven month period away and many people told me "Apply for all the jobs, even if they say BSN required." I have a BSN but they didn't know that so, I guess they figured I should know that hospitals are inconsistent in their "minimal requirements".

If I were to play "Conspiracy Theory" I'd say the powers that be like stirring this pot and watching us run around like Chicken Little from it.

1. Hospitals claim you need a BSN to apply. Yet they hire non-BSN trained people anyway. Why? It's simple: Act like you want a BSN trained nurse, then let the applicant think you're doing them a favor hiring them even though they don't have it. Cut your wage down a bit at the same time and.........no worries about you saying anything.

2. Schools profit from people running and getting their BSN thinking the day it is required is coming.

Just my two cents from what I've seen.

[AutumnApple]

Oh, one final note. Yes, I'm a chatter box. Sorry.

As far as whether it should be mandated or not, I say make BSN training more universal first then worry about that. Truth is, no one seems to agree on what the differences between BSN education and RN education are. I don't think we're all in agreement about exactly what a BSN trained nurse is so, how do you mandate an unknown?

Once we, ourselves, are more concrete on this point, then it'll be easier to answer whether it justifies being mandated or not. I'm BSN trained but when I talk to others about what they did in their RN to BSN programs.....it's completely different. There are some core similarities but for the most part, my program left me feeling like they had no idea what to teach and had a lot of "filling in the time" stuff for us. Thats just me though.

[Dogen]

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

The reason why your 3-year-old news article says Drexel's online RN-to-BSN program and hundreds of others like it expanded dramatically in a few short years is because a lot of RNs are going back for their BSNs... so... nurses themselves are already moving in this direction, which both shows they're not hiding their heads in the sand and pretending it doesn't exist and that many of them are actively preparing for the hyperbolic future you're predicting. So...

[Dogen]

As an ADN nurse, I do think we need a more streamlined educational pathway, and it makes sense that a bachelor's degree would become the entry point. But not under the current model of BSN instruction. I keep putting mine off because I know it will give me zero additional clinical skills and I have zero interest in a management position.

...

I guess I should also clarify that the RN-BSN programs around here have no clinical hours and are largely management and theory classes. The 4 year straight BSN programs are different altogether and preferable to splitting it given the current model, in my opinion. I shouldnt assume that all RN-BSN programs are the same.

My BSN had an annoying number of "leadership" classes. I need a leadership class like I need another hole in my head. I'm not opposed to them, exactly, I just had no use for one. I'd like to see the BSN curriculum revolve around clinical skills, pharmacology, and pathophysiology, and then have a couple of slots for electives. That's where someone who likes reading books with the words "policy" and "crucial" in the title could take a leadership class to get their fix, and maybe I could have taken... I don't know... wood shop or something.

[ThePrincessBride, MSN, RN, NP]

Whatever happens, I think nursing education needs to become more standardized and heavily regulated. Nursing missed the ball. While other professions with far less responsibility and skills started requiring masters and doctorates (think PT/OT, speech therapy, etc), nursing never evolved, and I think that has also contributed to the glut of nurses and wage stagnation. While I was taking my prerequisites, I came across too many other pre-nursing students talk about how nursing was a "quick" way to the big bucks and how it was "only" a two-year degree. I do think if we made a four-year degree a requirement, we would have less saturation in nursing and much more clout in terms of compensation, etc.

And I do think that all current nurses should be grandfathered. I think it would be unfair and unrealistic to expect people who are close to retirement to go back to school and take on more student loans. Plus, experience always outweighs education every single time.

[Oh'Ello, BSN, RN]

Whatever happens, I think nursing education needs to become more standardized and heavily regulated. Nursing missed the ball. While other professions with far less responsibility and skills started requiring masters and doctorates (think PT/OT, speech therapy, etc), nursing never evolved, and I think that has also contributed to the glut of nurses and wage stagnation. While I was taking my prerequisites, I came across too many other pre-nursing students talk about how nursing was a "quick" way to the big bucks and how it was "only" a two-year degree. I do think if we made a four-year degree a requirement, we would have less saturation in nursing and much more clout in terms of compensation, etc.

And I do think that all current nurses should be grandfathered. I think it would be unfair and unrealistic to expect people who are close to retirement to go back to school and take on more student loans. Plus, experience always outweighs education every single time.

MMmmm... I don't really want to participate in this discussion but this post got me. Where there is a patient there needs to be a nurse. However, where there is a patient, there does not necessarily need to be a pharmacist, physical therapist or a speech pathologist. Higher education requirements won't help nurses gain wage clout because we simply need too many of them for our healthcare system to function. If all nurses made a wage high enough to support themselves, their family and pay off masters and doctorates, healthcare would be too expensive for any patient to use. But alas, this is a failure of both our healthcare and education systems.

I feel like we should be congratulating nursing for having figured out how to teach and prepare individuals for such a complicated, high stakes profession in 2 years. Keep the BSN... it works. Keep the ADN... cause it works too.

[ThePrincessBride, MSN, RN, NP]

MMmmm... I don't really want to participate in this discussion but this post got me. Where there is a patient there needs to be a nurse. However, where there is a patient, there does not necessarily need to be a pharmacist, physical therapist or a speech pathologist. Higher education requirements won't help nurses gain wage clout because we simply need too many of them for our healthcare system to function. If all nurses made a wage high enough to support themselves, their family and pay off masters and doctorates, healthcare would be too expensive for any patient to use. But alas, this is a failure of both our healthcare and education systems.

I feel like we should be congratulating nursing for having figured out how to teach and prepare individuals for such a complicated, high stakes profession in 2 years. Keep the BSN... it works. Keep the ADN... cause it works too.

But requiring more education would most likely decrease the number of people pursuing nursing. I believe there would be far more PTs if one could become one in four years vs the six or so it takes to get a doctorate. Less supply, more demand. When that occurs, nurses can negotiate higher wages. However, due to the saturation of nurses and nursing schools, the market is in the employers' hand and they can afford to be picky and pay low wages.

[AJJKRN]

But requiring more education would most likely decrease the number of people pursuing nursing. I believe there would be far more PTs if one could become one in four years vs the six or so it takes to get a doctorate. Less supply, more demand. When that occurs, nurses can negotiate higher wages.

Requiring more education would potentially decrease the number of candidates going into nursing...this isn't stopping a glut of people pursuing NP education though. Whether or not there would be more PT students going into PT really doesn't make a case for increased or decreased wages in nursing...we still do not bill separately for our services such as PT's, OT's, ST's, etc so we do not command higher wages in the sense that we a just seen as a cost burden on employers because we are often the biggest hit to their wallets/profits. We'd likely get better wages if we weren't billed into the Pt's hospital stay like toiletries or furniture. JMHO!

[nurseprnRN, BSN, RN]

Homework question? Only a student would be asking it. The rest of us have lived c this issue for forty years.

[Oh'Ello, BSN, RN]

But requiring more education would most likely decrease the number of people pursuing nursing. I believe there would be far more PTs if one could become one in four years vs the six or so it takes to get a doctorate.

I agree that there would be a lot more PT's if the education requirement was lower. I also think there would be a lot more unemployed PT's if a bachelors was all it took. The point is the market just doesn't need as many of them as it needs nurses. If you'd like to have less nurses in nursing to artificially inflate your wage... perhaps you should also remember what that does to patient ratios.

Less supply, more demand. When that occurs, nurses can negotiate higher wages. However, due to the saturation of nurses and nursing schools, the market is in the employers' hand and they can afford to be picky and pay low wages.

Supply and demand economics is not static and isn't really relevant to labor economics. Just because one day hospitals decide nurses need MSNs or DNP's to practice doesn't mean that temporarily high demand will warrant higher wages over the long term. As soon as supply stabilizes, wages will stabilize too and those making "too much" get edged out.

Teachers are a pretty comparable example of this. Higher educational requirements has neither earned them competitive wages relative to their education, nor has it reduced the number of individuals pursuing education as a profession. Those who need their services... can't afford to pay them tons of money. So regardless of their education... their wages largely remain flat. I think nursing is pretty much the same. Requiring hundreds of thousands of dollars of education for a flat wage market isn't creating anything but poverty.

[brandy1017, ASN, RN]

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

Why does it bother you so much since you seem to already have your BSN? I think if BSN is mandated current RN's should be grandfathered in, but I have no more control over what happens than you do. We all have to make our own individual decisions on whether or not to go back to school for a BSN. There are pro's and cons and potential consequences either way. If 50+ nurses go back they will be facing student loan debt instead of saving for retirement. It doesn't make sense for a lot of us to go back to school. I don't want to be paying off student loans when I'm retired and living on social security! I plan to pay my house & car off and save for retirement. If I'm forced to get my BSN I will deal with it then and go for the cheapest program I can find.

As to state law requiring BSN, I've read North Dakota did this years ago and then had to backpedal when they couldn't find enough nurses so that has since been rescinded. In the end it's all about supply and demand, when there is a surplus than BSN it is, when that is not the case any old RN will do! The reason for the current surplus of RN is because it is one of the few jobs that pays a living wage that can't be outsourced and with the bad economy many are flocking to be RNs. Even the state of Michigan has a program to train laid off factory workers to be RN. Other states encourage nurse training programs to their welfare recipients to get them off the dole! I'm sure they are using the quickest, cheapest training for them to save time and money.

Where I work they still hire ADN RNs, not just BSNs. So I don't worry about this. I'm more concerned about having enough emergency savings and retirement savings because I don't want to do this forever. It is too stressful and hard on the body. I want to be able to retire early!