Concerns and Suggestions About the Future of the ADN and the BSN

I am finishing my BSN, FINALLY, and I have …. concerns

When you view the chart, realize that the higher in the chart you are, the fewer years of experience you are actually receiving.


Above is a link to a rough post where I have graphed a very rough flowchart of where I think nursing is heading. I believe current goals will result in a forced exodus of experienced nurses from existing acute care facilities when they are not able to accommodate their schedules and finances to higher education.

I believe the push for higher nursing education is a good one, but if hospitals want to keep their best nurses, they need to begin to formulate a plan that sets aside paid time for educational goals and work with universities to bring the needed education into the hospital. BSN programs need to be closely reviewed to be sure the information they are teaching ADNs is relevant to practice and the goal should be to increase knowledge of the ADNs instead of simply fulfilling the core tenants of a Bachelor’s degree. In a utopic situation, the course would be created so that ADNs coming into a BSN program would actually emerge with a certification reflective of their years of experience and knowledge and placing them higher in the nursing hierarchy than new graduate BSNs with no experience.

Yes. This will require hospitals to pay nurses floor pay to attend classes. The hospitals will benefit with higher patient satisfaction scores, lower patient injuries, and better physician/nurse relations. Many hospitals already offer education assistance and scholarships in exchange for time worked after graduation. This does not need to be any different.

If nurses have time set aside for classes that they are attending with their coworkers, they have a ready made support system, which is necessary for successful education. If nurses are allowed to work fewer hours on the floor while they are receiving their education, advancing ones education will not appear so monumental and burdensome.

As far as funding these paid hours that are performed off the floor, hospitals should look to their political force. This is a viable method that can be used to increase the knowledge and the size of the nursing force, at a time when an influx of patients threatens to cripple the current United States medical system. Nurses will emerge from these programs empowered, better team players, and will receive knowledge they can apply to the bedside at their next shift rather than trying to find time to take off work, struggling through APA format and trying to find a way to pay for their own college education as well as that of their children.

No ADN currently working full time should be forced to carry a burden of student loans to maintain their current career. This is a burden that many nurses with families and current student loan debt cannot handle. Instead of requiring 2 years of work in order to receive student loan relief, while paying student loans, give the relief IMMEDIATELY, and require nurses to pay back a prorated sum if they leave the area or change careers.

It is my belief that this kind of incentive is what is needed to get ADN nurses into BSN classes. Current BSN programs focus on papers and theory, but there is very little meat added to the pot of  nursing experience already held. This is a waste of the time of experienced nurses. Because it has already been decided that management roles should be held by holders of nursing doctorates and master’s degrees, only individuals who are interested should be required to take additional classes in nurse management.  Nursing programs need to be divided into tracks: Research. Management. Advanced Care. Hospital Management.

Instead of this, we have nurses sitting in History, Music and Philosophy classes to earn their BSN. All of these are valid courses of study but are they actually efficient for people whose priority is to get back on the floor? Nurses who have an ADN and have years of floor experience do not necessarily need these classes but could use classes in new techniques, evidence based practice, and advanced practice.

As a floor nurse who has worked in multiple hospitals, including LTAC, rehab and nursing homes as I made my way up from being a tech to a RN, I feel the the nursing profession is missing a valuable opportunity to increase the abilities of their current workforce while making nursing a more rewarding experience.

About Grimalkin, RN

Trying really hard to be a decent person. Registered Nurse. Intersectional Feminism. Poet. Cat. Political. Original recipes. Original Stories. Occasionally Questionable Judgement. Creator of #cookingwithjoanne and #stopcock. Soulless Unwashed Carrot. This blog is dedicated to my grandmother, my beloved cat Grimalkin, and my patients.

Posted on June 29, 2014, in Hospital life, Nursing. Bookmark the permalink. 2 Comments.

  1. You are correct in that the future of nursing is in higher education. Have you read the IOM report on the future of nursing? They call for more masters and DNPs at the bedside. That is where they belong, we need critical thinking and big picture people at the bedside.
    The focus of higher education is to make you well rounded. While you may not see the value in a history class when cleaning up a patient but there is value there. If your patient is a vet, you now have something to talk about beside his/her disease process.
    Bachelors degrees are tough because they do include a lot of subjects that may not be your focus. It’s meant to give you a broader sense of what life is about. As you go on to graduate school you’ll get more focused in your field.
    Enjoy your broader perspective of life, who knows someday you may actually use it.

    • Wow. You are really full of yourself!

      First.. have you been an ADN taking a BSN program? This is vital. BSN programs are insulting. RN-BSN students are often treated as if we had no nursing experience at all. The level of patronization from nursing professors at multiple colleges and universities was ridiculous. Getting my BSN was more like marking time than getting a degree. Indeed, while I may know a bit more about ancient history and philosophy, this has not made me any more well rounded than my volunteer work and personal reading. I honestly enjoyed most of the NON-NURSING classes I took, but the BSN classes offered at every college or university in my area were similar. Nothing I learned about nursing in my BSN program was applicable to my career. My hospital is pushing nurses to get their BSNs on the idea that it makes us safer nurses. I learned nothing new about safety in my BSN classes. I learned nothing new about science in my BSN classes. So how is the higher degree useful to patients if it doesn’t actually make us more skilled or more knowledgeable?

      In addition, I don’t need to take a college history course in order to discuss history with a vet or hold a conversation with a patient on a complex topic. An associate’s degree education does not limit the things a person learns outside of college. ADNs are not mindless automatons that only spit out details about disease processes. An ADN nurse has not only the skill of a nurse, but in many cases, years of continuing education, floor experience, committee experience and experience running the hospital.

      Getting a bachelor’s degree has not been “tough.” It has not made me more well rounded. I was a well rounded individual going into nursing, I didn’t need a Bachelor’s degree for that. Prior to getting my education as an RN with an ADN, I edited APA papers for journal publication. I worked in the tech sector for 5 years. I speak 3 languages and without college, managed to become educated on many topics. Indeed, I know a great number of individuals who are well read, well rounded, and well educated without having access to the financial wherewithal needed to gain a college education. A college degree is a status symbol, a sign of privilege, and it is not what is needed to be a well rounded individual.

      My ADN program taught me everything I needed to know about nursing, and it is a sad situation that nurses studying for their BSNs do not get more science and medical education unless they add classes to the program. I disagree with the call for MSNs and DNPs at the bedside. It is not a financially feasible solution to the nursing shortage. Advance practice positions are not necessary A better solution would be to encourage hospitals, through financial incentives, to make BSN programs more accessible and to pay nurses for the time spent getting their additional educations. In addition, the BSN could be revamped to include more science, more evidence based practice, and nurses would emerge from these fields better armed to handle changes in the medical field. What is the point of getting a BSN if you cannot apply what you learned in your program to your practice? RNs should come out of BSN programs with new information about EVP and changes in nursing theory and philosophy.

      Nursing academia is looking for a reason to show that it has purpose. By calling for nurses who want to work at the bedside to have higher and higher degrees, nursing academia finds a reason for itself to exist.

      Your reply to my post was patronizing and not helpful and really had nothing to do with my post, which suggests adding to the education that ADN nurses receive when seeking a BSN to make the BSN nurse a more capable nurse and make the degree process more rewarding. Implying that I was not a well rounded and whole person prior to the blessed experience of accumulating more student loan debt for a college degree and a minimal raise at work was simply an insult.

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