The education requirement for nursing is changing

[DichloroacetateAl]

It used to be that nurses did not have to go to college; we were instead trained by hospitals. Then the education requirement changed and community college replaced hospitals. And now, it is changing to that some hospitals will only hire nurses with college degrees. Undoubtedly, the education requirement will continue to increase in the future.

The downside to this is that it will make this profession harder to get into. And those who are in the profession will constantly need to adapt by going back to school. The upside to this is that it will provide us with more skills to do a better job.

What is your opinion on this?

[HouTx, BSN, MSN, EdD]

ADNs were introduced as an effort to increase the Nursing educational pipeline during WWII and they quickly became very popular.

Despite popular opinion, nursing is a "knowledge-based" profession. Sure, we do a lot of patient-touching, but the essence of Professional Nursing is the ability to analyze and make decisions based upon our knowledge of what is going on and what needs to be done. Unfortunately, current nursing jobs do not really differentiate by skill levels (due to a huge number of factors) so RNs are spending a lot of time doing tasks that 'someone needs to do' rather than limiting the work to RN-specific areas of practice. Let's face it, basic hygiene, endless documentation, road trips to pharmacy & central supply, filling out PI forms, . . . etc. could all be either automated or done by other types of staff. It's just cheaper at this point to use RNs. This may change if RNs become too expensive.

Like all other knowledge-based professions, basic educational requirements for nursing is increasing as the practice environment becomes more sophisticated. For example, years ago, a reasonably intelligent person could become a database administrator simply by paying attention to on-the-job training... These days? Employers require graduate degrees. So, why would nursing be any different?

[wish_me_luck, BSN, RN]

The education thing is because like others said, nursing used to be looked at as only a skill/trade (floor nursing) but it has evolved into it's own little world. Nurses can do a lot now--floor nursing, public health, research, management, etc. In order to branch out beyond the floor, you have to have higher education (Master's, Doctorate and post doctorate). The BSN allows for a person to do this (you can't go for a Master's or higher unless you have a Bachelor's).

[Dragonnurse1, ASN, RN]

For me I think there is room for both programs. When I went into nursing I had the choice to go ASN or BSN but I had no desire to go into management, research or public health - I wanted to work in an ER and that is what I did. I saw many new nurses that graduated with a BSN come to the ER as new grads and not one of them stayed in our department, they went to floors. I never worked on a floor so I do not know how floor nursing works but in our department we, as nurses, had the most autonomy in our hospital.

I do not know of a single doctor's office in my area where they employ any RN's so in what non-hospital area will ASN's work? I think there is room for both degrees. To snub ASN's because they do not have 65 hours of NON nursing education? The only reason I would have gone back to get my BSN and above would have been to get my NP. It is sort of like the military. It is nice to be an officer but the services cannot function without the grunts - you know - the NCO's and the enlisted men. Nursing can and should have room for both degrees.

[neurorn6]

I truly believe that it is a bunch of BS. The "boards" don't have different levels. From what I have seen, most BSN nurses just want to move on into management or get their NP. Bedside nursing is just a stop on the way. This arguement about our education is unproductive. It just divides us as a profession. While education is a starting a point. Experience seems to be overlooked too often in our world. This is non starter as far as I am concerned. I personally don't need alot of letters after my name. RN suits me just fine.

[DoGoodThenGo]

Yes they do; the BSN was first established in the early 1900s at Minnesota. I'm always confused when people seem to think the BSN is a new concept... the ADN didn't come into existence until the 1950s.

Following does a pretty good job of explaining things:

Associate’s Degrees in Nursing: The Road Ahead

While the BSN was basically launched to advance the profession of nursing, the ADN served to produce nurses with *some* college background faster than the normal three year diploma programs of the time.

The ADN also served the purpose of further removing nursing education from hospitals (where it had almost firmly been since Florence Nightingale and her methods deemed such places best to train and govern nurses), and give it to colleges. This fit in with the launch and growth of community colleges post WWII.

Movement of nursing education into colleges en masse, remember there had been BSN programs since the early 1900's but the major number of nurses up until about the 1970's or 1980's were diploma grads, coincided with a movement away from the apprenticeship/tasked based method of training nurses towards theory and rationale.

[DoGoodThenGo]

Education requirements for the nursing profession have always changed as the practice evolved to cope with changes in medicine and the healthcare system.

Hospitals and other facilities have been telling local schools of nursing for ages to step up their game if they wanted their graduates to be hired. What is happening in many local areas is that hospitals have stopped merely *talking* and setting down rules upfront as to what sort of new graduate they will hire, period.

Here in NYC for most intents and purposes whether or not one is able to land a new grad spot at any of the top tier hospitals/healthcare systems is determined in nursing school if not pre-nursing. NYP, NYU-Langone and others will only consider new grads with minimum of 3.0 GPA (NYU is 3.5) overall. In addition they want to see the same in all science classes as well. If you get a 2.5 or 2.9 say in A&P I or manage to graduate with only a 2.7 or so, then you pretty much are out of luck.

It does seem to me at least there is a movement away from merely posessing skills, to the value of critical thinking, problem solving, abillity to research and or interpet data.

[JZ_RN]

Uh, I went to community college and I have a college degree, thank you very much. Why do people say nasty things about community colleges? My ADN school had a higher NCLEX pass rate than the BSN program in a large and well-known 4 year school in the area. And we take the same freaking test either way. Busywork classes and citations and leadership nonsense do not make a better nurse.

[BrandonLPN, LPN]

The "BSN preferred" trend has much more to do with the tight job market then it does with hospitals actually thinking BSNs provide better care than ADNs. The only ones who seem to think so are a handful of "pie in the sky" academics who are far removed from the bedside. Millions of diploma and ADN trained RNs disprove this theory every second of every day.

[kabfighter]

I've been wondering recently that since many hospitals are using master's-educated nurses to fill management positions, why not completely change the BSN and make it more practice-based and leave the management courses to the master's degrees. I have an associate's degree, but I think that we need to become BSN-only in order to be taken more seriously as a profession. We arguably have the most responsibility over our patients' well-being throughout their hospitalizations, but are educated far less than any of the other allied health members (with the exception of respiratory therapy). Instead of slinging ASN vs. BSN crap, we should make the BSN more relevant to the work that the majority of nurses do and implement it as the entry-level education. Newly-graduated nurses are half-baked (at best) with clinical skills regardless of educational pathway, and another year of clinical in more diverse settings would be ideal. This would increase the quality of new graduates, slow the influx of new nurses into the workforce, make it more difficult for fly-by-night schools to open and operate, and help legitimize nursing as a profession. I've looked through my school's ASN-BSN curriculum, and I can honestly say that as a med-surg nurse, only two of the ten or so additional nursing classes would benefit me at all. Leave the nursing theory and leadership classes to the graduate programs, and make the BSN better.

[BrandonLPN, LPN]

If millions and millions of ADN RNs are providing excellent bedside care every single day, then WHY do we need to make the BSN the minimum requirement for the bedside, entry level nurse? CLEARLY it's not necessary if the majority of nurses provide 100% competent care without it. That's just common sense. Now, if the ADN nurses were proving unequal to the task, that would be a whole other story. But that's clearly not the case.

And since RNs (both ADN and BSN) already make more than most allied health care workers with university degrees, why do you *care* if they consider us "less professional"? Is what others think that important to you?

[kabfighter]

Is what others think that important to you?

As a matter of fact, yes. I have not yet transcended being human. Associate degrees are generally reserved for technical subjects and degrees that prepare for further education at a college which grants four-year degrees. Nursing is not technical; it is a profession with its own knowledge base and evidence-based practices. I'm not saying that those with associate degrees are unworthy of being practitioners of our profession, I just think that we can do more to better educate ourselves and come out of school more prepared for practice.

As I stated, I have an ASN, but I gave several reasons why I think that the BSN should be the entry-level education and suggested that it be improved to be more relevant. I pretty much stated that the BSN as it stands is not anything that I would be interesting in pursuing. The associate degree was meant to be a stop-gap measure to increase the supply of nurses during a time of increased need, and we are no longer in that situation.

Believe me, I very much understand where you are coming from, but I think that nurses need to be open to a bit more change as a whole. Nurses are not a hot commodity because we are so easily replaced due to the short schooling process. From what I've seen in many threads here, we are seen as disposable for the most part. If we make the hiring pool shallower and elevate our educational level a bit, I think we'd have more leverage to get our breaks and not be treated like crap by administrators. I think we may be the only professionals who have an entire site dedicated to complaining about how crappy our jobs are. We shouldn't expect our jobs to suck just because we're nurses, we should expect to be treated well because we are educated professionals who do a great deal of good in the world.

[netglow, ASN, RN]

The only reason we are even discussing this is the economic mess we are in. In all time prior to now, it's been universally understood that nobody is going to repeatedly put themselves in debt to chase rising minimum education thresholds for a job that will always require the wiping of butt.

Simple as that. When the economy gets bad, people get desperate. Nursing is what it is. You can't make it different by throwing money at it, BECAUSE you might have every letter combo possible after your name on your badge, after years of forcing more debt on yourself - when someone's butt needs wiping, they are still gonna look to you to do it.