Still don't get the BSN ADN thing...

[tarotale]

One of biggest mysteries I had after I started nursing was: BSN increases patient outcome. What? Just because I shoved up few more dollars into greedy university's rear, that makes me a better student? I used to think that I must be a badass and better than ADN because they are from community college (wooo), but find out, they take exactly same classes as we do, take the same test, and tadaa~ does exactly same things as we do; I met many ADNs and few of them being charge nurses, I didn't even know they were ADNs until they brought up the "I need to/am working on BSN right now." My unit auditor is ADN, and she is great! All BSN serves to me personally, is that it takes less time for me to achieve MSN, and that is it.

I have heard of the studies that show that BSN hospitals improves patient outcomes and resuscitation outcomes compared to ADN hospitals, etc but I can't help but doubt that. I'm a BSN but my degree does not upgrade my brain magically to remember the ACLS algorithm or to push epi better than the ADNs; it's really all experience and that's it. Is it a money thing for universities? Or was I lucky enough to work with only cool ADNs. Maybe someone has good explanation to this?

[MyCall2Nsg]

As a diploma trained nurse who have worked with an array of ADN, ASN, BSN nurses I have seen the good the bad and the indifferent when it comes to clinical skills.

I believe Professional and Person Goals has a lot to do with the education trend but also the changing directions in nursing plays a big part. Personally speaking, I have always wanted to have my degree. I am working with ASN trained nurses who want to have their degrees and I have talked to people who asked "Really, you don't have your degree? Why, I thought you already did." Thankfully they won't be asking that for too much longer.

I say hats off to all nurses who have a degree and those who are working towards getting one!!

While I do not think having more education makes one a "better nurse," I believe it does a lot for providing resources and it does a lot for ones morale, and I think it shows a level of commitment and dedication to the profession.

[applewhitern, BSN, RN]

I remember when diploma nurses were abundant. They practically lived in the hospitals. Their skills were exceptional. The ones I was familiar with lived in a dorm in the hospital-based nursing school. They actually went to school for several years. If someone needed a urinary catheter, a chest tube, an IV, etc., the students had to do it. Every day, not just in clinicals. Those nurses could get out of school and hit the floor running; no lengthy orientation required.

[BostonFNP, APRN]

I don't think he/she meant to offend anyone. It is a difficult situation to handle, at least when it comes up in the professional arena.

As a personal example, I frequently have students that come to shadow for a few hours with me (and these are mostly students who aspire to continue in to their NP degree/certification, so not fully typical) who are in ADN programs. Nearly all of them say they chose ADN because their "program has a better reputation than all the BSN programs around".

I know this isn't the case in my area, and in fact, I know they will have a very difficult time getting a job without a BSN, let alone a job in the PICU in the major academic hospital they are planning on. I also know that they will have a hard time getting to their ultimate goal of being an NP. So what do I say? Normally I keep my mouth shut and just encourage them to take what job they can and to make steady progress towards their goal. Inevitably they tell me that they can "get a job anywhere" because their advisor told them that. They also tell me that their program is the most difficult to get into; this is due to the fact they wait list everyone, get everyone taking prereqs, and eventually let them in once their number comes up.

After some conversation back and forth it always comes down to a personal reason they chose ADN over BSN be it prior academic performance, finances, chronology. It is rarely for the original stated reason. For better or for worse that's what I normally see.

If I try and mention the job market then they get offended. If I don't say anything then I worry I did them a disservice.

Obviously the job market varies by locale. But the trend is, for better or worse, clear re: job prospectus.

[Nonyvole, BSN, RN]

There are ADN programs that are highly competitive, and there are ADN programs that aren't. A good chunk of the ADN students that I met were from for-profit schools that have advertised the lack of waiting lists. On the flip side, the local community college had a waiting list period of four years...and that was if you met their requirements. They've since changed their admissions practices, but not their standards.

It wasn't my intention to make a general statement about ADN programs not being competitive or having high standards. I was stating my observations about some of the students that I have met and the statements that they gave me. And the students that I was referring to were belligerent towards everybody and rather, shockingly, critical of any program that wasn't their own. Is that true of all of the ADN students that I have met? No! Of course not!

My apologies if what I wrote came across as critical of ADN programs. It truly wasn't my goal.

[Esme12, ASN, BSN, RN]

I don't think he/she meant to offend anyone. It is a difficult situation to handle, at least when it comes up in the professional arena.

As a personal example, I frequently have students that come to shadow for a few hours with me (and these are mostly students who aspire to continue in to their NP degree/certification, so not fully typical) who are in ADN programs. Nearly all of them say they chose ADN because their "program has a better reputation than all the BSN programs around".

I know this isn't the case in my area, and in fact, I know they will have a very difficult time getting a job without a BSN, let alone a job in the PICU in the major academic hospital they are planning on. I also know that they will have a hard time getting to their ultimate goal of being an NP. So what do I say? Normally I keep my mouth shut and just encourage them to take what job they can and to make steady progress towards their goal. Inevitably they tell me that they can "get a job anywhere" because their advisor told them that. They also tell me that their program is the most difficult to get into; this is due to the fact they wait list everyone, get everyone taking prereqs, and eventually let them in once their number comes up.

After some conversation back and forth it always comes down to a personal reason they chose ADN over BSN be it prior academic performance, finances, chronology. It is rarely for the original stated reason. For better or for worse that's what I normally see.

If I try and mention the job market then they get offended. If I don't say anything then I worry I did them a disservice.

Obviously the job market varies by locale. But the trend is, for better or worse, clear re: job prospectus.

I agree....when I went to school....BSN programs offered NP at that level. I didn't want to be a NP (as they were NOT favored by the MD's and for some MD's still aren't favoring the NP...their loss) My program was a 2+2 program 2 years RN plus 2 NP. My 2 year program no longer exists at that university it is now the ABSN program. I LIVED at school even though I lived at home. We went to school every day and in the summer. We went to school on weekends. We started clinical when it was our turn at like 4 or 5 AM to insert all the pre-op foley's or NGT and to start lines.

I think with the proliferation of ALL of these ADN schools some of the programs are not looking for a quality education but a quantity of applicants paying exorbitant fees and tuition. No one really wants to really work for anything anymore. I think in this process the actual quality of the education has somewhat diminished....and I blame the BON's that approve them to function; however, kudos to the national accrediting entities that do not accredit them.

The writing is finally really visable on the wall. When looking for nursing programs for my daughter I found that many of the "good" ADN programs were the cost of a state college 4 year BSN programs. I also found that one of the most inexpensive BSN programs in the state actually had the highest NCLEX pass rate (97-100%) for the past 10 years...consistently on the top 10 with several of the other schools direct entry MSN programs. . The only supposed "top" program my daughter was denied ranked 88th on NCLEX pass rate....says something about the school IMHO.

I have told my daughter...the writing is on the wall...plan on a MSN ASAP before life gets in the way. But I still don't think that ALL associate degree nurses should be forced back to school under the guise of "better outcomes"....most, it not all, of the online RN-BSN programs IMHO do nothing whatsoever to add to nursing practice.

[applesxoranges, BSN, RN]

One thing that did bother me is that it's hard to come up with research articles in last three or four years about BSN graduates have better outcomes. When I was looking in depth a few months ago, it seemed like a lot of the pieces were citing a handful of particular studies that had been done over five years ago or they were opinion-based "response to the editor" situation.

I also think that there is some degree elitist issues. Each person thinks their program was better or harder to get into. In my area, my associate degree school ranked top in the NCLEX pass rates at the time whereas a BSN program is on probation because their pass rate is too low.

[akulahawkRN, ADN, RN, EMT-P]

The ADN program I got into was absolutely fantastic and actually does have a stellar reputation in the area. I've talked to former grads and other nurses from the area over the past few years and what I hear from them is that the students from my school are very well prepared to take care of patients when they show up on their clinical day. If any or all of their assigned patients aren't there for whatever reason, they're able to pick up another patient load and go.

The school very much does recognize that there are elements that they do not offer that a typical BSN program does. They've done the research and the know exactly what they "lack" in terms of being able to award a BSN degree. They don't lack much at all...

I'm not saying that the program I attended is better or worse than any BSN program around. I'm just saying that there's not much difference between them at this point. Is BSN on the horizon for me? Yes it is. I will get that degree because of the career and educational options it opens up for me and that's always been in the plan from day one. Would I have gone the BSN route from day one had that route been open to me? Yep. I had no choice in the matter.

I actually have some MSN options that are essentially open to me NOW because I do have a healthcare related Bachelors.

[BostonFNP, APRN]

One thing that did bother me is that it's hard to come up with research articles in last three or four years about BSN graduates have better outcomes. When I was looking in depth a few months ago, it seemed like a lot of the pieces were citing a handful of particular studies that had been done over five years ago or they were opinion-based "response to the editor" situation.

I also think that there is some degree elitist issues. Each person thinks their program was better or harder to get into. In my area, my associate degree school ranked top in the NCLEX pass rates at the time whereas a BSN program is on probation because their pass rate is too low.

For your own research.

Aiken, L. H., Sloane, D. M., Bruyneel, L., Van den Heede, K., Griffiths, P., Busse, R., ... & Sermeus, W. (2014). Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational study. The Lancet, 383(9931), 1824-1830.

Chicago

[tntrn, ASN, RN]

The ADN program I got into was absolutely fantastic and actually does have a stellar reputation in the area. I've talked to former grads and other nurses from the area over the past few years and what I hear from them is that the students from my school are very well prepared to take care of patients when they show up on their clinical day. If any or all of their assigned patients aren't there for whatever reason, they're able to pick up another patient load and go.

The school very much does recognize that there are elements that they do not offer that a typical BSN program does. They've done the research and the know exactly what they "lack" in terms of being able to award a BSN degree. They don't lack much at all...

I'm not saying that the program I attended is better or worse than any BSN program around. I'm just saying that there's not much difference between them at this point. Is BSN on the horizon for me? Yes it is. I will get that degree because of the career and educational options it opens up for me and that's always been in the plan from day one. Would I have gone the BSN route from day one had that route been open to me? Yep. I had no choice in the matter

I actually have some MSN options that are essentially open to me NOW because I do have a healthcare related Bachelors.

I graduated with an ASN in 1976 from a similar school....back when they were still called Junior Colleges. Our State Board Exam results were better than any nursing school in all of California.

Never once did I wish I had those extra letters behind my name; only once and it was only until my sanity returned, did I ever think I might want to become a nurse manager; I loved the bedside nursing I did. A good nurse is a good nurse....you don't need a BSN for that. Doesn't mean a BSN won't be a good nurse, just that it isn't necessary.

[happyinmyheart]

The ADN programs in my area are very easy to get into. No wait list, you can get in directly out of high school. The BSN schools in my area are VERY competitive. However... Also in my area, you have no hope of getting a job without your BSN. I believe that where you live plays a big part in which educational route you take..

[applesxoranges, BSN, RN]

For your own research.

Aiken, L. H., Sloane, D. M., Bruyneel, L., Van den Heede, K., Griffiths, P., Busse, R., ... & Sermeus, W. (2014). Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational study. The Lancet, 383(9931), 1824-1830.

Chicago

The biggest question is how does a European bachelors compare to a BSN in the US? One component is that in some cases, they remove the "fluff" classes that I do not agree with requiring (like fine arts) and they specialize sooner in their major. Usually a bachelors degree is around 3 years.

So a fair study to apply to the US?

Speaking of bachelors, there was a nurse from Australia that posted on here within a year that her bachelors wasn't viewed as a BSN in the US because she didn't have the general education credits necessary. Which is a shame.

[hope3456, ASN, RN]

Precisely. Why would that study even matter in the U.S.? To my understanding, European nursing education differs so greatly from the model here in the states that our BONs give them (nurses from Europe) no credit for it at all. They have to start all over to get a U.S. Nursing license. I am not the expert - please correct me if I am wrong.