Requiring a BSN degree for an ADN scope of practice

[Gentleman_nurse]

I recently attended an interview which BSN nurses were preferred (essentially required but they couldn't say so) but the duties were not upgraded. The position was at an ADN level of knowledge, skill, and ability. A BSN would be very hard pressed to use their advanced skill set in the position. Even with places that do require a BSN degree, the position doesn't require BSN knowledge. With the all shortage of positions and changes in nursing policy I'm sure this a common practice. I am a firm believer in education but this trend makes me uncomfortable. It's a waste of talent and doesn't increase the professionalism of nursing.

[llg, PhD, RN]

I think the BSN NCLEX would include things like:

1. Knowledge of research processes and standards

2. Knowledge of evidence-based practice processes and the ability to evaluate the research literature for quality and applicability to practice.

3. Knowledge of teaching principles (for preceptor, staff education, and patient education roles)

4. Knowledge of basic leadership/management principles

Not on the supporting courses and electives taken by a lot of nursing students such as the basic sciences, art, languages, etc.

The scope of practice could then be written to include functions such as management and teaching roles ... the supervision of others ... the evaluation of evidence for policy development ... etc. I would limit some of those activities to BSN nurses only. For example, some states currently have laws that say that NICUs need to have at least one person on the leadership team who is certified in that specialty. Similar standards/regulations could be written to say that everyone's orientation needs to be coordinated by someone who has at least a BSN ... or that Nurse Managers need at least a BSN ... or that the people reviewing/developing nursing care policies need at least a BSN ... etc.

[dream61792]

The ASN vs. BSN debate causes so much separation. The "My degree is better than yours debate". We are one field that there is so many routes to take (Lpn-RN, RN-BSN etc.) sorry to say but it is all about money. Get a ASN for $6k less chance of landing a position. Get a BSN for $30k higher chance of getting hired. The real focus should be patient-centered care. No matter which route you take nursing is difficult and tedious.

[Esme12, ASN, BSN, RN]

I hate to argue this point again...but who does everyone think did all of this work before the "BSN" became such a buzz word and concept idea.

I was a director of an ICU/CTPACU/ED critical care patient services for several years.....as an ASN. I have been a manager of an ICU and an ED (which got PERFECT score, special recognition for the JC accreditation) as well as house supervision/administration of a 300 bed facility.

I took statistics, theory, research classes all apart of my ASN ( which is now the accelerated BSN program at that university) Evidence based practice was policy and procedure and standard of care before it got a fancy name and package. I also took ethics and legalities of nursing which examined the nurse practice act of my and other states and how they vary.

All with my ASN. My BSN gave me nothing that added to my practice...NOTHING. But I didn't pay for mine my employer wanted it recently...so they paid for it. I did learn however how to write a paper using the APA writing style.

I'm all for the BSN to be entry...it's time...and I'm very tired of hearing the same thing over and over and over again. My daughter startes her BSN on Tuesday...one because my program doesn't exist and I do think the quality of some (most) ADN programs are lacking...and the BSN entry is her future and not her terminal degree.

But I do grow tired of hearing that the ASN nurses are less of a nurse than anyone else. It simply isn't true.

[toomuchbaloney]

I'm with Esme.

Until someone can produce some actual evidence that ADNs are not competent to function as registered nurses in most settings I will ignore the notion that they are somehow less than BSNs as nurses.

The preponderance of the evidence clearly shows that ADN RNs are fully capable of functioning safely, effectively, and professionally in many, if not most nursing environments (including management roles).

[monkeyhq]

That seems completely unfair to those who have real life experience in management, research, supervision, teaching, leadership, and evidence based practice processes (which are taught in most ADN programs, by the way).

So the question remains, what about the thousands of ADN nurses that are fully qualified (based on experience in the above disciplines) for a BSN, but don't meet the 'college degree' standard for a BSN?

Can they 'test up', so to speak? Or is this 'reward' of an 'advanced license' only available if a RN pays a university for it? And what about economic divisions? Some well-qualified nurses simply cannot afford to pay for a four-year degree, and tuition is going up at an alarming rate. Nor do many have the time with working full-time, raising families, and living life.

I would contend that RN's with their BSN already have the reward: their BSN. That makes them much closer to earning a MSN than an RN starting from ADN. If one wishes to teach RN's full time, go for the MSN (as it is now). If one wishes to be an NP, go for that degree.

Nonetheless, we are all still RN's, and I don't believe our value as nurses should be determined by the letters after that "RN". It should be determined by our practice. I see no value in diminishing the status of RN's that do not have the ability to pay for additional college work, but have equal skills.

As for requiring RN's to have BSN across the board at entry level (including LTC, outpatient services, clinics, PO, etc.), I think that would end in a statistical disaster, and extreme under-staffing in many areas of the country. (Sadly, a four-year degree is out of reach in this country for a tremendously large group of people due to cost and/or location, and that reduces the pool of capable persons available in a field that is practiced on every corner of the earth).

Once again, I state all of this with the utmost respect, and without sarcasm.

I apologize if this debate has been had before...I am relatively new to the forums so I did not participate in any of them before.

I'll shut up now, lol.

[roamingtheworld]

Gentleman_nurse, could you please explain this ADN scope of practice to me and tell me where I could find it? My state has an RN scope of practice and makes no reference whatsoever to degree. And, yes, I was just being facetious.

Currently, it is an employer's environment, not an environment that favors the job seeker. Employers have the right to set their own requirements for positions; however, that may end up not in their favor in the future should a true nursing shortage reappear. The fact is, many employers are seeing an unbelievable amount of applications for a small number of open positions. My bet would be that requiring a BSN either eliminates those without from applying or those that do apply without the degree will have their applications ignored.

[Fiona59]

So, real question. Up here in Canada the degree has been the only way to become an RN since 2009. Does the OP think all of the diploma and hospital trained nurses should be down graded?

The PN education up here is the old diploma course, so in his way of thinking all of those RNs without degrees should now be LPNs.

[applewhitern, BSN, RN]

Most of the hospitals in my area no longer pay (or assist with) tuition. If you want to advance yourself, you are on your own money-wise. The ADN program was designed to get nurses into the workforce faster, during a great shortage of registered nurses. Fear not, the ADN isn't going anywhere, esp. when the next shortage arises, it will be in vogue again. In my state, an RN is an RN is an RN.

[roamingtheworld]

So, real question. Up here in Canada the degree has been the only way to become an RN since 2009. Does the OP think all of the diploma and hospital trained nurses should be down graded?

The PN education up here is the old diploma course, so in his way of thinking all of those RNs without degrees should now be LPNs.

I think the only benefit of requiring a BSN is that it would stop all of the infighting inherent in nursing re: entry level degree. However, Canada did it the right way: all of those already licensed were grandfathered in. Not sure about those already in programs so could those of you in the know enlighten me?

I started as an ADN, and recently completed an online BSN program. While I think that ADN nurses are certainly competent and worthy of the title registered nurse, I sometimes wish that someone would finally make the call, just to stop the endless debates that have been raging since the ANA first brought up the BSN entry level statement in 1964. Obviously, if it were so important, it would have happened in the 50 years since. But if it does happen, those already working and those already in school should be allowed to continue with an ADN. There should also be plenty of assistance for programs to convert from ADN to BSN.

[Fiona59]

The diploma course offering institutions all knew of the degree requirement and took in no students who would not graduate by a specific date in 2009. I work several graduates of this last batch of diploma RNs.

[monkeyhq]

The diploma course offering institutions all knew of the degree requirement and took in no students who would not graduate by a specific date in 2009. I work several graduates of this last batch of diploma RNs.

That is not the case in Ohio. We have diploma RN programs here.

[Meriwhen, ASN, BSN, MSN, RN]

Advanced in walls of academia. I was referring the core nursing science courses such as community health, nursing research, and health assessment.

Last time I checked, health assessment was a significant part of any ADN or diploma nursing program, as well being as a significant part of any ADN/diploma RN's nursing practice...heck, any nurse for that matter regardless of their degree. After all, assessment is what we do as RNs, right?

Also, the Health Assessment I learned in my BSN program wasn't that much different than what I learned in the ADN program...actually, in that department, the BSN program sucked in comparison. Point being: there's no special assessment tricks that they save for teaching only to the BSNs.