"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?

[MunoRN, 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.

We've managed to avoid some of the degree inflation that has hit the rest of the job market, I don't think that's a bad thing.

I don't think it's at all accurate to say that nursing "hasn't evolved", looking at nursing program curriculum over the past 20 or so years it's actually pretty impressive the amount of evolving that has occurred. I don't think that what letters are attached to the end product of that curriculum really has anything to with evolving, it's the content of the curriculum itself.

I hear this claim frequently; if BSN was the minimum requirement then we'd get paid more. There is absolutely no reason to believe this would be the case. Why does it seem like that would happen?

[Rose_Queen, BSN, MSN, RN]

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.

Even in the days of the true nursing shortage, there may not have been a shortage of licensed nurses; only those willing to work. How many nurses who hadn't been working as nurses came out of the woodwork when the whole economic fiasco happened? It's not the lack of nurses that contribute to the crappy ratios; it's facilities not being willing to spend the money to staff safely and the lack of legislation that mandates adequate ratios.

[AllieSparksRN]

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

=

"The Chicken or The Egg." Which came first?

Two questions I think we can debate either way for hours and hours...and decades and decades...

[Oh'Ello, BSN, RN]

Even in the days of the true nursing shortage, there may not have been a shortage of licensed nurses; only those willing to work. How many nurses who hadn't been working as nurses came out of the woodwork when the whole economic fiasco happened? It's not the lack of nurses that contribute to the crappy ratios; it's facilities not being willing to spend the money to staff safely and the lack of legislation that mandates adequate ratios.

I'm not talking about the nursing shortage and nurses unwillingness to work. I'm talking about reducing the number of nurses eligible to work because of a lack of education. If we were... tomorrow, to abolish all nurses from patient care who have less than a masters education (or bachelors for that matter), I guarantee you patient ratios change...dramatically, whether or not your state or hospital system has mandated ratios or not. OR maybe they don't, but it's hard to ask for ask for more money if the hospital isn't making as much on admissions (because they can't staff the beds). Remember, we're talking about this in relation to other disciplines, PT, OT, Pharmacy. All of those disciplines require masters and even doctorate level educations but an individual PT in an inpatient setting where I work, evaluates and works with 20-40 patients A DAY.

Of course since we're all so great at delegating we can just supplant the system with more aides! But I think that already happened during the true shortage and was a patient safety and health outcome disaster.

[applewhitern, BSN, RN]

It amazes me that the associate degree programs (at least, many of them) have eliminated the requirement for chemistry, a surgical rotation, and other things that I had years ago in the associate degree program. We continuously get new grads who have NO clinical skills, require lengthy orientations, etc., and I hate to say it, but our BSN grads seem to know even less than the associate degree new-grads. Instead of requiring everybody to have a BSN, maybe the question should be, why don't nursing schools teach actual nursing? Also many of the online RN-to-BSN programs have eliminated the practicum. You just take a handful of classes and BOOM, you have a BSN, regardless whether you actually know more or not. Our unit has become a nursing school in itself, it seems. New grads who have never seen or done anything. How does a BSN change that?

[OCNRN63, RN]

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.

So, all those non-BSN graduates from the 70s-early 90s were out there practicing inferior nursing care all this time? You'd think people in hospitals would have been dropping like flies due to the ineptitude of their nurses.

[Nanceenurse123]

Nursing is the only profession where you don't need a Bachelor's Degree for the entry level. I think it hurts nursing, as a whole, because, in general, the more educated you are, the more respect you get. It's just a fact of our Western society. Nursing has to evolve and change. The BSN should have been mandated years ago.

[brandy1017, ASN, RN]

Nursing is the only profession where you don't need a Bachelor's Degree for the entry level. I think it hurts nursing, as a whole, because, in general, the more educated you are, the more respect you get. It's just a fact of our Western society. Nursing has to evolve and change. The BSN should have been mandated years ago.

The more education you have doesn't magically gain respect, yet alone a job that requires a BA degree. I have worked with so many CNA's who have a bachelors it isn't even funny. They make $10 to 15 at the most and it doesn't matter that they have a degree. A patient talked to a cashier at a grocery store who had a BA degree from a nationally ranked private school making $12/hr because that is all she could get! I spoke with a Walgreens cashier who too was making $12/hr with a business degree who was planning to go back to school and become a nurse. The majority of these BA/BS CNA's are back in school to become RN's because that is where the jobs are that pay a living wage, but know they will have even more student loans to pay back. Education doesn't automatically equal respect or even a good paying job.

[42pines]

Grandfathering.

But it's a fairly moot question. For instance I took a job 9 months ago with the stipulation: I will get BSN within two years. (which I shall).

So even if it does not become state reg, many hiring entities will get'cha anyway.

[anh06005, MSN, APRN, NP]

I like what some other posters have said:

Associates for LPN

Bachelors for RN (but with more focus on clinical like in diploma programs)

Now before anybody takes it the wrong way all nurses would be grandfathered in with whatever they have. And I respect and love working with nurses from ALL levels and the local LPN program churns out AWESOME nurses and their NCLEX pass rate has been 98-100% for as long as I have been paying attention....

I think all nurses should have some formal prerequisites to take (bio, anatomy, etc.) LPN's included. I wish all nursing programs across the nation would have a fairly set standard of prerequisites as well as nursing courses and amount of clinical hours.

Sure it's great to know how to read a research study but how many of us actually read them? Not many. If I need to know best practice I go to a professional source and do some digging for their recommendations and rationale...not the study itself

I wish things were more regulated for advanced practice programs also.

I just think it's tough for some professions to take us as seriously when you can throw a rock and hit a nursing school that may have a NCLEX pass rate of 60%. Rather than churning out nurses why don't we focus on providing CONSISTENCY in the nursing profession?.

[subee, MSN, CRNA]

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.

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.

Teachers are doing better than nurses, IMHO. They have a defined pension, life-time health care and about 8 months a year. No shift work. Accepted as a profession requiring a master's. No comparison to nursing. I think police work would be a better comparison. They have positions which require different levels of education but one can enter the group with an associates. After that, opportunities depend on education. Lots of shift work, lots of stress.

[MunoRN, RN]

...

Associates for LPN

Bachelors for RN (but with more focus on clinical like in diploma programs)....

It's an interesting idea on the face of it, but I've never heard anybody explain how that would work. How would we alter ADN curriculum from what it is now? How would it work to have half as many RN's as we have now? Would we extend BSN programs to 3 years or shorten ADN programs to 1 year? What would their clinical roles be? etc.