ADN vs. BSN
Even though I am a graduate from an associate degree program and never received my bachelor’s degree in nursing, I am a true advocate of ending the associate degree programs in nursing. In the excerpt from “A Curriculum Guide for Schools of Nursing” (1937), it was recommended that nursing students have a least one to years of education beyond high school before entering the nursing program. They also recommended that the nursing education should lead to a bachelor’s degree.
Frances Reiter also believed that nurses need a bachelor’s degree level of education. She believed that “nurses, to be truly profession practitioners, required as broad an education as those entering other health professions.” (Hiestand, 2006). I absolutely agree with her. The associate degree program was started to help with the nursing shortage. The nurses graduating from these programs were supposed to be considered technical nurses and to work under advanced degree nurses, namely a BSN. Today, more nurses graduate from an associate degree program than a bachelor’s degree program. (Meyer, 1997) I know from my experience, I do not work under an advanced nurse and the hospital does not pay a higher rate for those with advanced course work.
I asked myself these questions: So why have we gone backwards? Because there is a nursing shortage, is it okay to allow this to occur? Would you want your physician to graduate medical school sooner because there was a shortage? What are we then saying about nursing - that level of education for a nurse is not that important? How will nurses ever be looked at as professionals, if we and others in the health field have this opinion? If the public was made aware of this study, how would they feel?
There was a study by Linda Aiken, et al (2003) which found that “in hospitals with higher proportions of nurses educated at the baccalaureate level or higher, surgical patients experienced lower mortality and failure-to-rescue rates.” There was much talk after this study came out, especially because we all know, and may be ourselves, associate educated, and are excellent nurses. But my education was lacking greatly. The program tried to cram all the requirements into four semesters and it is just not possible. My cultural education was lacking, my community health education was lacking, my nursing history was lacking, and overall, my nursing education was lacking. The nursing program I graduated from had a 98% pass rate on the NCLEX exam, but I soon realized that I was not well prepared. As stated by Meyer (1997), “Educators in AD programs often increase the content to prepare student for more advanced roles, however this is frequently at the expense of other course content.”
Many students apply for AD programs because of the same reasons I did. The first reason is time, second is money, and my third reason was why would I go through the time, money and effort to get a bachelor’s degree, when I can make the same money and do they same type of work with an associate’s degree. Many of my students today feel the same way. There is no incentive to strive for a bachelor’s degree, and many have no desire to further their education in the future. When asked why, their answer is “For what?” Until there is a forced change, AD programs will continue to exist and expand. In the journal article by Meyer (1997), it cited the PEW Health Professions Third Report (1995) which “recommended closure of 10-20% of AD nursing programs.” Meyer also called for nursing organizations to differentiate practice. AD graduates would be technical nurses, while BSN graduates would be professional nurses. I don’t know if this alone would work. I believe that AD programs will not go away. But AD graduates should be required to finish their bachelor’s degree in a required amount of years, and until then only be allowed to work in certain areas of nursing. This will help fulfill the need for nurses, it will differentiate practice, and it may drive many nurses to achieve higher education.
References:
Aiken, L. H., Clarke, S. P., Cheung, R. B., Sloane, D. M., & Silber, J. H. (2003). Educational levels of hospital nurses and surgical patient mortality. JAMA, 290(12), 1617-1623.
Committee on Curriculum (1937). A Curriculum Guide for Schools of Nursing (copy 3-52)
select readings from this section.
Hiestand, W.C. (2006). Francis U. Reiter and the Graduate School of Nursing at the New York Medical College, 1960-1973. Nursing History Review, 14, 213-226.
Meyer, C.L (1997). RN, ADN, BSN: clarifying differentiated practice. Kansas Nurse, 72(9), 1-2.
Frances Reiter also believed that nurses need a bachelor’s degree level of education. She believed that “nurses, to be truly profession practitioners, required as broad an education as those entering other health professions.” (Hiestand, 2006). I absolutely agree with her. The associate degree program was started to help with the nursing shortage. The nurses graduating from these programs were supposed to be considered technical nurses and to work under advanced degree nurses, namely a BSN. Today, more nurses graduate from an associate degree program than a bachelor’s degree program. (Meyer, 1997) I know from my experience, I do not work under an advanced nurse and the hospital does not pay a higher rate for those with advanced course work.
I asked myself these questions: So why have we gone backwards? Because there is a nursing shortage, is it okay to allow this to occur? Would you want your physician to graduate medical school sooner because there was a shortage? What are we then saying about nursing - that level of education for a nurse is not that important? How will nurses ever be looked at as professionals, if we and others in the health field have this opinion? If the public was made aware of this study, how would they feel?
There was a study by Linda Aiken, et al (2003) which found that “in hospitals with higher proportions of nurses educated at the baccalaureate level or higher, surgical patients experienced lower mortality and failure-to-rescue rates.” There was much talk after this study came out, especially because we all know, and may be ourselves, associate educated, and are excellent nurses. But my education was lacking greatly. The program tried to cram all the requirements into four semesters and it is just not possible. My cultural education was lacking, my community health education was lacking, my nursing history was lacking, and overall, my nursing education was lacking. The nursing program I graduated from had a 98% pass rate on the NCLEX exam, but I soon realized that I was not well prepared. As stated by Meyer (1997), “Educators in AD programs often increase the content to prepare student for more advanced roles, however this is frequently at the expense of other course content.”
Many students apply for AD programs because of the same reasons I did. The first reason is time, second is money, and my third reason was why would I go through the time, money and effort to get a bachelor’s degree, when I can make the same money and do they same type of work with an associate’s degree. Many of my students today feel the same way. There is no incentive to strive for a bachelor’s degree, and many have no desire to further their education in the future. When asked why, their answer is “For what?” Until there is a forced change, AD programs will continue to exist and expand. In the journal article by Meyer (1997), it cited the PEW Health Professions Third Report (1995) which “recommended closure of 10-20% of AD nursing programs.” Meyer also called for nursing organizations to differentiate practice. AD graduates would be technical nurses, while BSN graduates would be professional nurses. I don’t know if this alone would work. I believe that AD programs will not go away. But AD graduates should be required to finish their bachelor’s degree in a required amount of years, and until then only be allowed to work in certain areas of nursing. This will help fulfill the need for nurses, it will differentiate practice, and it may drive many nurses to achieve higher education.
References:
Aiken, L. H., Clarke, S. P., Cheung, R. B., Sloane, D. M., & Silber, J. H. (2003). Educational levels of hospital nurses and surgical patient mortality. JAMA, 290(12), 1617-1623.
Committee on Curriculum (1937). A Curriculum Guide for Schools of Nursing (copy 3-52)
select readings from this section.
Hiestand, W.C. (2006). Francis U. Reiter and the Graduate School of Nursing at the New York Medical College, 1960-1973. Nursing History Review, 14, 213-226.
Meyer, C.L (1997). RN, ADN, BSN: clarifying differentiated practice. Kansas Nurse, 72(9), 1-2.
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