RN or BSN?

Pride of July28 · Aug 11, 2003

cOASTAL-

thanks for the reply. I am looking into Rn-MSN programs for after I finish my ADN. I was looking at direct entry msn programs like Vandy, Cloumbia, Yale and I really don't wanna do a 3 yr entry to practive program if I an go to my local school do an RN, get my experience and learn what I'm doing and if I want to go on to ADV practice or into education get my masters in the bridge and get my BSN only as a biproduct of the bridge.

PLUS- @ $$73,000/yr Columbia is a bit expensive (to put it lightly) to get my BSN if there are bridges available down the line if I do well in my ADN that wil ave me a year's time and tuition.

All other perspectives welcome and appreciated

nowplayingEDRN · Aug 17, 2003

We educate ourselves like blue collar trailer trash and then wonder why we are payed, compensated, and treated as such. We get what we ask for. ........We need to make the BSN as entry into practice, phase out diploma and ADN programs, eliminate the career track of LPN's...............
Nurses have educated themselves they have moved away from the bedside, not because they don't want to do patient care, but because they are not rewarded or appreciated for their education. ........... I hope that I have given people who deride BSN's some food for thought.

First let me say that each and every one is entitled to their opinions, for every one has one.....just like evryone has a rectum (being PC here folks but you get the underlying drift). I am and have been ADN nurse since 1992. I do not feel like I was educated like blue collar trailer trash. I feel that I got an excellent education and I feel at this current point and time in my nursing career that I am respected for my professionalism and knowledge. No, it was not always the case. There was a point when it did not matter if you had a BSN, ADN or Diploma degree......you got no respect from Management. Management looked at you like you were nuts for asking for a raise and your educational background was not an issue. It was just the fact that we were nurses in a world of cut backs with no recognition for when a job was well done.

I do not think it helps to pound 1 degree or another into the ground. All have equal benefits and there is something to be learned from one another. I think that past experiences of other n urses precepting BSN nurses have influenced opinions, like the old adage, The first impression is a lasting one.....ADN and Diploma nurses have seen where in precepting a BSN graduate that there was little emphasis placed on clinical skills and more placed on the management end of the world, which is fine but we again need to be reminded that we all started at the bottom of the dog pile and that is why we as the more experienced are paired with the new grad, to help impart the knowledge we have gained so that others can have the same level of knowledge and skill. however, there are times that even the best of teachers can not help a person and someone can be incredibly book smart but lack the ability to put that knowledge into practice...seen it...sad really but it is not my fault or anyone elses.....it is just a fact of life. It takes all kinds to make the nursing world go round and there are some people that management is their cup of tea and other who feel that they do their best at the bedside, caring for the patient and assisting the doctor as needed. This does not make for a bad nurse.....a person becomes a bad nurse when they loose the vision that they had upon entering the profession and that is a difficult task in this day and age. Just like a manager becomes bad when he or she forgets where they one started out and forgets the people working under them.

As for phasing out the career tract of the LPN, that I do not think is a very good idea. I know that there have been times that I would have been lost with out the assistance of my LPN and my CNA. LPNs provide valuable care to patients just as the dedicated CNA does and any RN in the trenches knows that your subordinates can make or break you and can be the difference between a busy or "bad" shift being a complete and total disaster and nightmare. Phasing out the LPN career path is only hurting those that would go on in their educational pursuits that you so passionately advocate for. A bit of a double standard on your part, it seems to mee to deny a person the ability to move upward and onward in their educational pathway. I am all about bettering the education of those in the trenches as improved education and increase in knowledge provides high quality care for the patient. But having worked union for a while, I am not in favor of putting Unlicensed Assistive Personnel on the floors in place of the LPN. There is no replacement for personnel with a license...as it is indicative of a higher practice standard that must be adheared(sp) to.

You say that nurses leave the bedside as they become educated because they feel unrewarded. I do not think that is necessarily the case. The higher the degree the bigger the push toward leaving the bedside and entering the world of management. I do not k now the stats on advanced degree nurses staying in a clinical setting so I can not say that yes, the advanced degree nurses are staying or leaving the clinical setting.

I do not think that your statement infering that there are people on here that look on a BSN negatively. I think that what is happening is that there are a large group of nurses that are comfortable in the positions they are in or they are just simple not financially able to pursue an advanced degree. That coupled with people just like you beating them over the head because they do not have a BSN makes for a sour taste in their mouths. Instead of pounding on them, support them for who they are and what they have to offer the nursing profession. You say people entered nursing because it is a quick way to make money but i have to tell you that i ran into very few of those people, Linda. Most of the nurses that I have met or associated with or worked with entered nursing because they wanted to make difference in the lives of people, money was just an added bonus. And if you are in the profession to make a fast buck, then i would suggest that you might want to rethink your career path as I would be inclined to question your dedication to the profession and the quality of care that is meted out to the patients under your care.

PS: Someday I'd like to pursue an advanced degree but at the moment I am too far in debt trying to help my spouse realize his dreams of obtaining a higher education so my education will have to wait.

PSS: Never be ashamed to used something you are entitled to. I applaude the person that takes pride in their profession and any certifications that thay have worked hard to atain

Christie, RN, TNCC

nowplayingEDRN · Aug 17, 2003

costal,

I would suggest that if you can afford it, go for your BSN as it will give you more options (ie: management and teaching) However if you know that you have no intrest in going on to teach or take a management position or are strapped for cash...by all means go for your ADN. Look for a school that has an outstanding pass rate. (The ADN program that I graduated from had a 98% pass rate on the NCLEX exams) But then again, you want that in any school that you attend.

PS: And when Istated that my advanced degree would have to wait, that does not mean that I have to put my learning on hold. There are plenty of ways to continue to stretch and expand my knowledge base.....articles, conferences and the like)

Daisy Marie · Aug 29, 2003

Hello Linda,

Thank you for your comments. I certainly agree with you. I am currently in the process of working on my BSN. I have known for years that I need to have the education in order to communicate more effectively as well as increase my own respect for myself. I see so much complacency amongst Nurses. I attribute our lack of motivation to negotiate for our patients, for our wages and benefits to our minimal education. I wish that I had gone straight to a BSN program. I am finding it much harder now due to the demands of having a family, and a career. However, I believe that, that which does not kill you, will make you stronger. It's a stollen quote, and I don't know who said it.

I can't wait to use my college degree next to my name!

Daisy Marie

ainz · Aug 29, 2003

Well I LOVE these kinds of threads that just beat the "old dead horse" to death again and again and again when it comes to entry level degree for nursing.

I was an army medic for 6 years, got out of the military and earned my ADN because it was the quickest route to get a job as a nurse (RN), 10 years later earned my BSN, 4 years later earned my MSN. I am in process of figuring out how to earn my PhD.

I am proud to be a RN. I love nursing and the role nursing plays in healthcare delivery. I am pro-nursing and I consider myself a die-hard advocate for the advancement of the profession. I have made it my business to study and examine healthcare and nursing and the issues that prevent nursing from being recognized as a true profession. I have also made it my business to get myself into a position to be able to make decisions that promote nursing and the value nurses bring to healthcare. So it is kind of like fighting with your brother or sister, I can beat them up all day long but no one else better dare touch them!! :)

I agree with nearly everything that "Linda" had to say in her post, as a matter of fact I wondered if she had just read one of mine. Nursing has been around a long time, unfortunately steeped in tradition established in the 19th centry--isn't this the 21st century????? Talk about resistance to change!! Nursing is full of it, that is why we continue to have age-old debates such as this.

We are generally the least educated of all of the allied health professions. As "Linda" pointed out, physical therapy, pharmacy, OT, speech therapy, even dieticians and now dental hygienists have advanced the degree requirements to enter the profession. Why is this? Why are we so resistant to raising our standards? These other professions have seen tremendous increases in their pay over the past 10 years, nurses have not. These other professions have gained much more respect while nursing has not. Other professions have slowly and steadily taken away tasks and responsibilities that used to be nursing and have incorporated them into their own professions as we sit by and complain about how "powerless" we are to do anything about all of this and blame it on the old mean administrators and arrogant doctors.

Why is this--because society values higher education. We can sit here and defend our 2 year degrees (oh yeah--it really took me 2 and a half years to get my ADN) and talk about how there is no difference in our direct patient care skills and so on. The fact remains and will always remain--society values higher education--period.

It makes absolutely no sense to me, and is also very detrimental to the advancement of nursing as a profession, when we have LPNs, ADNs, BSNs, RN to BSN to MSN, online degrees, and whatever else is available now and we all are called "nurse." For nursing to advance as a profession there has to be a single avenue to become a "nurse." Again, there is no judgment of anyone in that statement, it is simply a fact.

The BSN should be the entry level degree to write the NCLEX, obtain a license to practice as a RN, and to get a job working as a RN. Some of the earlier posts questioned the worth of a broad, liberal basic education before taking the actual nursing courses. Look at all of the other professions--they ALL REQUIRE IT!!!! Why? It expands your total body of knowledge and broadens the frame from which you view things, consider things, analyze things, and critically think as you are going about doing "bedside" nursing or any other kind of nursing. It increases your vocabulary, your communication skills, it stimulates you to consider new ideas, it increases your awareness of the world around you, it prepares you to go into a more highly specialized focus of study because you have the basic building blocks of education as a foundation from which to begin!! How can anyone say there is no worth in the coursework required for the BSN?!?!?

Fact is--nursing will never advance as a profession as long as we have LPN, ADN, BSN that all lead to allowing a person to write an exam, get a license, and be called a nurse. It is simply not the mark of a profession. It also speaks volumes about how nursing values, or does not value, higher education.

So YES!!! IT IS ANOTHER EDUCATION THREAD!! I hope there are more and more threads like this, so many that one day we will all get the message------higher education means more pay, more respect, better working conditions, more autonomy, Hey!! Isn't that what nurses are all upset about these days, because we lack these things?!?!? Come on guys, can't we get it together, unite, and move forward on at least one issue?

I hope you all noticed that I did not say one thing about whether an ADN or BSN or LPN is or is not a better or worse nurse. It is really not about that, it is about higher education and professionalizing nursing so that we can advance ourselves and get out of the rut we are stuck in.

poki · Aug 29, 2003

I always hear that statement about old nurses eating the young nurses. That's probably one of the reasons of the nursing shortage. There should not be space for envy because of degrees obtained if all what matters is the health and healing of our patients.

TeenyBabyRN · Aug 29, 2003

As ADN, Diploma, and BSN are all accepted avenues of entering nursing, and (as some have posted) ADN and Diploma prepared nurses tend to be more clinically prepared as new grads than BSNs, does anyone else feel that it is totally ridiculous that RN-BSN programs require additional clinicals for experienced nurses (as if an experienced RN would have less clinical experience than a BSN new grad)?? I can understand the additional theory, the transitions classes, advanced pathophysiology and the like...but clinicals?? What's up with that?

SnowieRN · Aug 31, 2003

You know.. I dont think the patients cares how long you went to school, at the end of the day.. your all R.N.'s :)

Brownms46 · Aug 31, 2003

Originally posted by cheerfuldoer
I am an ADN graduate of 16 years now, and the opportunities that I have experienced as an ADN have been tremendous! Personally, I still do not see the need to get a BSN. It will NOT make me a better nurse than I already am as an ADN.

I have been far more than simply a "bedside nurse". As a matter of fact, I have never thought of myself in those words.

I have been a Clinical Instructor for CNAs. I have been a Preceptor of nurses irregardless of their degree choice.

Education cannot make one a nurse in and of itself. One must pass the NCLEX to become a licensed nurse. Simply by graduating from a college...two, three, or four year....does not a nurse make. You may have the degree, but without the license, you are simply a college graduate with hopes of working as a nurse one day once boards are passed.

I'm all for people pursuing education. I'm also all for people pursuing the educational path of their choice whether it be two, three, or four years.

With every job comes opportunities to advance. When and if one cares to do so, that is when they should research what it will take to have that particular advancement on their job. If more schooling is the case, then go for more schooling. If certification is the case, go for the certification, and so forth.

In the summer of 1987 when I stood in a line of about a thousand nurses waiting to take my two full days of handwritten exams to become the nurse I wanted to be, a few graduates of a four year program approached myself and a few others standing in line and had the gall to ask "Which line is for the BSNs?" I told them to go to the line that was forming at the top of the hill and that would be the line for the BSNs.

After they walked ahead of us, we all started laughing our azzes off because they were stupid enough to bite that bullet and believe it! :rotfl: :rotfl:

Many BSNs think that just because they went to school for four years....the first two years are mostly college required non nursing classes anyway.........that entitles them to special privileges.

When I precepted BSN students as an ADN graduate, they were the hardest to precept because they did not know how to do the "bedside stuff" you referred to. I still see many of the BSN graduates coming into the hospital with the mentality that they are "above" bedside nursing" and must simply "NOT stop there!"

How sad, but true! We cannot ALL be Chiefs! There aren't enough "in charge" positions to have for all the four year nursing graduates to own.

A student must ask themselves this question when considering nursing:

Do I have what it takes to care for sick and dying people in a healthcare setting? Am I afraid of the hands-on care that I will have to give? Are bedpans, baths, vital signs, making beds, and helping to feed complete patients "beneath me?"

If management is what a nurse wants, then pursue that. The ony reason I am considering advancing the educational level I have is because I hope to own and operate my own hospital one day.........a hospital for nurses by nurses. I would not hire any nurse who thinks she or he is above elbow deep shick when it comes to caring for the patients. I will also alleviate the painful multiple paperwork that many of the BSN graduates create for nurses in the first place because all they have on their minds is having something that "stands them out among the rest" as nurses.

I have worked, and work with now, some really great nurses. But not because of the degree they chose to obtain, but because they are just great nurses who passed the boards because they learned how to apply what they learned while training to become an excellent clinical nurse!

No place is wrong to start. As a matter of fact, I think I'll only hire diploma and adn grads who worked as diploma and adn grads awhile before furthering their education. Why? I liken it to being in the military. The best Officers are the ones who first served as Enlisted Noncommissioned Officers. Sometimes nurses who graduated from a four year degree think that entitles them to "a special place" over and above the other nurses they work with.

Encourage and support one's choice of education. Let them decide how much they want or need. Just be supportive.

Hmmmm insert LPN for ADN, and this starts looking very familiar. No flames anyone...I'm done, but just couldn't let it go:cool:

nowplayingEDRN · Aug 31, 2003

No, I am sure that the patient does not care what your degree is as long as you have RN after your name...and I will also add to that....I don't care what your degree is...as long as when you are at the bedside giving professional care that you administer that care with skill, compassion and professionalism.....it is unskilled, uncompassionate and unprofessional ignoramus' that I have trouble with. I do not think that a degree makes one more professional than another but the carraige of the person speaks volumes.....yes, ADNs typically have better clinical prep than a BSN but show the world that you possess skills and knowledge....not just initials after our names and we will get the respect that is due us......continue to behave cattily about degrees and each other and we will always be looked upon as subprofessional......just a bit of observation and common sense

ahill1000 · Sep 2, 2003

Cheerfuldoer....I've only just registered to take part in this nursing forum maybe 10 minutes ago, and to my disappointment, I came across your multiple, long-winded replies to a possibly aspiring nurse, Cynthiann. I wanted to take part in a forum in which I could share opinions and feelings with other nurses as well as provide and receive support. As we all know with a profession such as ours, the latter is so important. To start, I am an RN. BSN that is. It seems as though you feel it requires 75 lines of text to defend your ADN. If you really felt that strongly about it, the "bedside nursing" comment would not have struck such a soft spot. I thought nothing of it whilst I read it. My understanding was just as Cynthiann said, unless you have a BSN, YOU CAN'T ADVANCE. Sure you can manage a unit or even a department of the hospital for that matter, as well as a multitude of other opportunities. We all know that. The diversity and options of nursing are what enticed most of us to this field anyway! Her point only being that you can't further your education and become a university educator, a nurse anesthetist, a nurse practitioner, a nurse midwife, as well as many other higher administration positions that require an MSN. Not to mention the satisfaction of having a "real" college degree and that sense of accomplishment that goes along with that. Particularly if you have no ambition of furthering your education. The only "slap in the face" anyone has witnessed here, my fellow BSNs, LPNs AND ADNs alike, was not administered by Cynthiann, but was very bluntly and clearly administered by you, and you alone. In no context did Cythiann degrade the intellect and nursing care of the ADN nurse. But in reading your replies and comments regarding BSN nurses, clear degredation and disrespect was apparent. For anyone who read them, this is apparent and need not be

repeated. I on the other hand feel no need to defend my bachelor's degree in nursing. The wonderful education I received, I feel has better prepared me to take a wholistic approach to nursing, thereby understanding and relating to my patients in a way I truly believe I may not have been able to fully grasp without it. This includes the "useless courses." Also, I'm sure other BSNs will agree that prior to you reading so much into two little words, very few of us if any ever gave a second thought to who makes a better nurse, BS prepared or AD prepared. I know I never have. Very often on the units I usually work, (I float), I am the only one out of every nurse on that floor that even has a BS degree. And even more often than that, I may be the only RN. This has to do with the fact that I work a lot of Rehab and SNF which is mostly staffed by LPNs. And we all have a wonderful working relationship. If we provide bedside care, we are all there for a common goal; to provide safe, efficient, and compassionate care to our patients, BSN, LPN, or ADN. In your reply, you grouped all BSNs into one category. I must have been out sick the day we had the class on "I think I'm better than you." As a matter of fact, we were all out sick that day. It is the individual that makes a good nurse. It is the individual that chooses the "I'm better than you" mentality. (That of which I have yet to meet). By the way, if you do your research, since the 1970's, the American Nurses' Association has encouraged and pushed nurses to only obtain their BS degree, simply for the fact that whether we like it or not, we still have not completely gained the "professional" status with MDs as well as the general public which nursing has for so long tried to obtain. Please, stop reading into what other nurses say. We are in this together, and as you said, to support one another. So quit the nurse bashing.

I completely agree with "Linda". We need to make that push to strictly BSN to start. Before you know it, medical assistants will have our jobs providing direct patient care, just as we are slowly becoming obsolete in the MD's office and being replaced by MA's. If you aren't aware of this, do your research. I only found this out 6 months ago. They draw blood, give injections, take vital signs, and assist the doctor. What's next? That's a scary thought.

P.S. My closest sister has her ADN and is currently practicing and my mother obtained her BSN 20 years ago, only 4 years after obtaining her ADN. She is the best ER nurse I know.

Well, that was my piece.

ahill1000 · Sep 2, 2003

Originally posted by lindarn
I am about to ruffle a few feathers. I was originally a diploma nurse from a school in NYC. I moved to California in 1979, and two years later I started the BSN program at Cal State Long Beach. Why did I pursue a BSN? Because I realized a few short years into my career as a nurse how woefully under prepared I was as a diploma nurse.

I am not talking about my clinical skills- I am talking about surviving in the world of business that nursing and hospitals have become. Nurses are the least educated medical professionals in the hospital and have the most need to BE more educated. We should be ashamed of the 19 th century educational preparation that nurses continue fight for.

When I was taking my BSN classes, I did a paper in my senior year about the BSN/ADN/Diploma debate. We can say all we want to that the public thinks the world of nurses, but turn around and ask them if we should be making a professinal salary commensurate with the education that we do have, the inconvenience to our and our families lives, and the constant threat of work ending injuries. Nurses have a rate of on-the-job injuries second only to construction workers. Ask the public that question. Unfortunately, and I hate to bust your bubble, but the public equates worth with education, something that nurses are severely lacking!

We educate ourselves like blue collar trailer trash and then wonder why we are payed, compensated, and treated as such. We get what we ask for.

At a time when physical therapists already have a masters as entry into practice, I have just recently heard that they are going to a doctorate as entry into practice. Occupational Theraspists also have a masters as entry into practice, as do social workers. Pharmacists have a doctorate as entry into practice. They all enjoy far higher salaries than RN's do, along with the professional treatment, and much more respect.

Nurses seem to think that their statutory title of RN should bring them the professional salaries that other medical professionals enjoy, but the fact of the matter is we haven't earned it. As we say in Brooklyn, that and 50 cents will get you on the subway. As we are finding out, it is worthless.

We are neophytes and quite unprepared when it comes to dealing with the hospital administrators. When we ask for more and higher wages and benefits, I wish I had nickel for every time I heard from administrators, patients, the public, "what do you expect? You only went to school for 2 years! And you what, they are right.

I can hear the whining now! "But I only could go the school for 2 years! I didn't have the money to go into a BSN program". Lets face it folks- people got into nursing because it is one of the easiest ways to make a buck, compared to PT's, OT's, Speech therapists, pharmacists, etc. I include other career fields as well. In these fields there is no choice- Bachelors degree, or higher. When someone really wants to be a PT, OT, pharmacist, dietician, etc, they figure out a way the be able to complete the educational requirements and complete the program. Nursing, on the other hand, always wants the easy way out- it has become the welfare of women's professions. It is the first choice of welfare- to work moms who would be otherwise ill- prepared to enter other fields. This may sound nice, but the nursing profession has suffered from a lack of support and appreciation. Nurses are incapable of seeing big picture. Nursing will never come into its own as a profession because of it lack of, and appreciation of higher education.

I makes no differance to me if BSN's have less clinical skills than diploma and ADN graduates. I don't recall doctors being skilled enough to perform brain surgery and heart transplants right after they graduate from medical school. That is what residency and internships are for. Even PT's and OT's have an internship after they graduate from school. And they have master's degrees. There is more to professional practice than technical skills .

As to pay scales, there is no reason the BSN's should not be paid more. I don't care if they are doing the same job. Teachers with master's degrees teaching in the same school, with the same years of experiece, teaching the same grade, make more money than teachers who only have a bachelors degree. Period. There is nothing to debate. Education is appreciated and rewarded.

We don't get paid more because hospital administrators don't want to pay nurses more and they practice the "divide and conquer" routine. They stroke the egos of the diploma and ADN's and say, "See, the BSN's want more money and they do the same job the you do!!." Nurses fall for it hook line and sinker and it gets voted down in unon contracts every time. Instead of insisting that nurses who have higher degrees be rewarded, our own peers need to validate their self worth and self inportance by dumping on those of us who improve ourselves through education and earning and maintaining professional certifications. We are looked down on and made fun of for attempting to improve the image of nursing. And it will not improve until we do. We will forever be the disposable interchangeable widgets who can be replaced by cheaper, and less educated personnel. Our lack of higher education leads the public and the adminstrators to think that, if a nurse with only 2 or 1 years of education can do this job, surely a nurse's aid with a GED can do the same. Make no mistake about it- that is what the train of thought is with the pubic and the people who arre paying for our services think. Unfortunately, we do to. We are forever apologizing and making excuses for our lack of education. We are not paid and treated like professionals because most of us are not.

We need to make the BSN as entry into practice, phase out diploma and ADN programs, eliminate the career track of LPN's, and improve the education of nursing assistants. PT assistants and OT assistants do a fraction of what nursing assistants do, and have a 2 year associates degree to become PT and OT assistants. That is ridiculous. As it stands now, nurses with less than a BSN are indentured servants in the hospital. They have minimal career mobility to better paying jobs. Work in a doctors' office is notoriously low paying, as is home health, and clinics.

Nurses have educated themselves they have moved away from the bedside, not because they don't want to do patient care, but because they are not rewarded or appreciated for their education. The individuals with the motivation and the desire for better paying jobs attain the higher education that is needed and required for the better paying jobs and career fields. Nursing is losing these individuals with motivation and who have the most to offer, to other career fields that don't look down on higher education- a "brain drain".

That is my 0.02 cents on the subject. I hope that I have given people who deride BSN's some food for thought. We will never be cohesive and a power to be reckoned with until we unite under a a common educational background that is commensurate with other health care prodesionals- give the diplomas and ADN's a grandfather clause to allow them to continue practicing, as pharmacists did. Make it easier for them to earn a BSN- give them credit for their diploma and ADN classes. As it stands now, the colleges make you jump through hoops to get your classes approved for a BSN- it should not be. We have to do this soon before we lose our entire practice to technicians. We are giving away our professional practice and make it easier for the hospitals to replace us, and we have never learned to how fight at the bargaining table, or beat them at their own game. We have a long way to go.

Linda, RN, BSN, CCRN
(yes, I use my college degree in my title as well as my specialty certification- I earned the right to use them)

I couldn't have said it better myself.