Requiring a BSN degree for an ADN scope of practice

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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.

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
Can the "I don't like the BSN degree" discussion have its own permanent thread here at AN? That will streamline this process a great deal...;)

I have been on AN for a while now. I have never read of anyone who dislikes the BSN degree. I wonder who you could get to take part in that discussion.

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Specializes in burn ICU, SICU, ER, Trauma Rapid Response.

Then what do we have on the other side of the debate? The people that sell the other product telling us that the studies published just aren't true, just because.

What we have is a debate. One in which I find both sides to have very compelling arguments.

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Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
I think because there was a report that patient outcomes are better with BSN nurses there is a push for magnet status at hospitals.

The "push" for Magnet is long over. What we have is the best of the hospitals, many of whom were early adopters (and many more top hospitals who neglected to follow the Magnet fad at all), more and more not even bothering to recertify. This who are still, at this late date, pushing for Magnet are pretty much the dregs of health care and looking to slap a big MAGNET band aid over their shortcomings and mismanagement.

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I think a big part of this debate, and likely a component of patient outcome, is the inconsistent amount of clinical hours for varying institutions of learning. This is not ADN or BSN specific, but four-year universities and CC's tend to (but not always) require significantly more clinical hours than a for-profit trade school. In addition, 4Y programs and CC's typically have an agreement with the larger hospitals, whereas the for-profit trade schools are generally more limited in the types of healthcare institutions available to them.

I don't know this to be the case across the board in the US, but it is quite consistently true in my state for 4Y and community colleges to have more clinical hours, and they almost always perform them in major hospitals. Pass rates for the NCLEX are generally greater in the CC's and 4Y than they are for students coming out of a for-profits trade school.

None of this is to say that the students who pass are not properly prepared. How prepared one is mostly up to the individual. That said, if a brand new graduate who has never worked in healthcare before enters the field of nursing with similar curriculum, but differing clinical hours, the student from the school with the most clinical hours may have a greater likelihood of being more prepared for direct patient care. Of course there are many potential variables and exceptions.

Instead of presuming that better patient outcomes are due solely to BSN degree nursing staff, it would be interesting to to see a study conducted that includes a lot more variables. For instance, number of clinical hours pre-entry, residency/new employee training programs of the hospital, years worked in hospital, average age of staff, average salary of staff, trauma level of hospital, # of beds v. staff (nurses, managers, physicians, PCT's, broken down by profession), for profit or not-for profit, # from 4Y state funded / 4Y private / CC / for-profit trade school /diploma programs, # of years worked in healthcare pre-entry, post-entry, etc.

I do think that there needs to be a universal requirement for the number of clinical hours expected at the LPN and RN level, and that every school must complete the same number of hours in the same types of settings, with the % of clinical hours broken down between Med-Surg Hospital, LTC, Clinics, OB/Ped, children's. That would ensure that every nurse (with the exception of those that have experience in the workforce in healthcare) has the same exposure and training. I think this is a more important component to patient care than having advanced Algebra and Western Civilization. If RN's from both tracks are passing the NCLEX, it makes more sense to focus the improvements on actual patient care, i.e. a standard clinical hour requirement, no matter the program or school.

As a stated in an earlier post, I am working on my BSN. But I am not so certain that I will perform any better as a nurse because of it. And I know I outperform some BSN's, and some ADN's kick my behind. And some BSN's kick my behind. In all truth, the one's who kick my behind the most are the nurses who have the most experience as nurses.

Just my thoughts...

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Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
Having "virtually the same curricula" for 2 different levels of education is not a sensible thing for a society. It has nothing to do with the capabilities (or lack thereof) of individual people who may have attended one type of program or the other. If there are 2 different degrees, there should be 2 different curricula.

Why should there be? Other professions seem to not be very bothered by multiply entry points. It doesn't bother me.

For example Physician Assistant. One can become a PA with an associates degree, bachelors degree, or a masters degree (like RNs!). The curricula seems to be pretty much the same between all of them (at least to me). Yes I don't detect the angst over different entry points among PAs that I do among nurses.

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Just a bit of a clarification is required here, I think: The BSN is not an advanced license, and therefore 'testing up' is clearly not part of the equation. An RN doesn't "pay a university" for a higher license, they pay the tuition for courses that (eventually) will result in a higher college degree.

In a nutshell: no, if someone has not earned all the college credits required for a BSN, they shouldn't be granted one, regardless of experience. After all, who hasn't heard of people in various fields who can 'run circles around' the guy with a higher college degree.....but still doesn't HAVE that degree? In the case of nursing, it isn't about who is a better bedside nurse, it's just about achieving a higher level of education. Experience is entirely different than college education.

And this is coming from an ADN nurse ;)

Yet experience is what's needed to handle critical care issues in their relative environments. Overall, when I look back at my career I feel frustrated personally. Granted, I'm taking steps to comply with what I feel is a skewed educational model. Not the core curriculum mind you, I'm speaking of the tangents and outliers. In my case I've a dual BS in Bio/Chem. This qualified me for admission into medical school. After making the decision I wanted to be a nurse instead I was completely turned off by the waiting lists in my state of residence. I ended up taking the first thing that opened up, which was indeed an LPN program. Following completing it and being licensed, I began working.

Enter more waiting lists, family illness, and yay obligations. The first of many disappointments involved those lovely waiting lists. Nonetheless, what really solidified my disdain for the model was being denied credit for my already completed degrees. This remained consistent even in the online programs I've had communications with. There was one exception, University of Phoenix. Even they wanted to negate over half of my completed work. There is a funny story there I'll share sometime when I feel more comfortable here. Sadly I don't have 40k + to hand them even if I did falter on my principles and decided to get it over with.

Experience being different from college education... in some cases that's true. Perhaps even the majority actually. Though that statement doesn't include my specfic case, or people like me. I have education... and experience.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Those threads have nothing to do with "disliking" the BSN degree. It is about being told after 30 years you are no longer good enough and need to get some letters after your name....which in most RN-BSN programs add NOTHING to your nursing practice.
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Specializes in Nephrology, Cardiology, ER, ICU.

While I do agree the BSN did not make me (former LPN and ADN RN) a better nurse, it was a springboard for the MSN and post MSN certificates that I hold.

That said, lets just keep it civil folks. Thanks.

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Specializes in Critical Care Transport.

Looks like the OP should have done some research or thought out his post when creating this thread.

While I personally have no bias either way, many hospitals are now seeking BSN prepared nurses. If you have the ability to pick from a bunch of candidates with similar knowledge, skill, and grades why would you not hire BSN prepared nurses? It looks good on paper (helps with magnet status) if nothing else.

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Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
While I do agree the BSN did not make me (former LPN and ADN RN) a better nurse, it was a springboard for the MSN and post MSN certificates that I hold.

That said, lets just keep it civil folks. Thanks.

It may have been "a springboard" it isn't for everyone. The health system I work for has a very generous program to pay for BSN, BAN and MSN degrees for it's nurses. Many of the ADN RNs are now skipping the BSN altogether and doing RN to MSN.

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