The Never-Ending Nursing Education Debate

Robyn Tellefsen | April 5, 2011

Here’s the funny thing about the nursing profession: with three very different education paths to take, you’ll end up with the same job no matter which one you choose. Whether you earn a diploma in nursing, an associate degree in nursing (ADN), or a bachelor of science in nursing (BSN), once you pass the National Certification Licensing Examination (NCLEX), you can become an RN. Are all nursing education paths equal?

“The BSN is better.”
The American Nurses Association, the American Association of Colleges of Nursing, the American Organization of Nurse Executives, and the Carnegie Foundation for the Advancement of Teaching say no. In line with its latest nursing education study, the Carnegie Foundation recommends that the BSN become the entry-level qualification for nurses – no nursing diploma or ADN program options in sight. And, similar to teachers, RNs should be required to earn a master’s degree within 10 years of licensure.

With more than 60 percent of new nurses being educated at community colleges, pro-BSN professionals say this translates into the lion’s share of nurses being less qualified for advanced education opportunities. All of the advanced practice nursing specialties – clinical nurse specialists, nurse anesthetists, nurse-midwives, and nurse practitioners – require a master of science in nursing (MSN) for entry. And perhaps more to the point, without an MSN, a nurse cannot move into a faculty position – a key issue, given that nursing school applicants are being turned away because of the nursing faculty shortage, which in turn perpetuates the nursing shortage.

In addition, these nursing organizations cite research that shows that lower patient mortality rates, fewer medication errors, and positive care outcomes are linked to nurses trained at the BSN and MSN levels.

“The ADN is essential.”
The American Association of Community Colleges (AACC) and the National Organization for Associate Degree Nursing take a decidedly different stance. In a recent policy brief, the AACC contends that both ADN and BSN programs teach students the competencies necessary to become an RN, as demonstrated by comparable pass rates on the NCLEX as well as hiring statistics. Plus, ADN programs educate the majority of RNs in rural settings, and they also provide the greatest number of minority RNs. Minorities in nursing are instrumental when it comes to understanding and addressing the care needs of our diverse population.

These nursing organizations also point out the lack of a valid correlation between nursing education level and patient outcomes. In other words, a bigger degree does not necessarily make a better nurse.

What’s a nurse to do?
Is advanced nursing education valuable for its own sake? Will you be a better nurse if you get a bachelor’s degree instead of an associate degree?

Obviously, there are no easy answers, but whichever nursing education program you’re leaning toward, there are a few key considerations to factor into your decision. Make sure the program is accredited, and that the NCLEX pass rate is high. If you choose an ADN program, look for a community college that has an articulation agreement with a four-year nursing school so that you can seamlessly transition into a BSN program if you choose. Look into RN-to-BSN programs… or bypass the BSN altogether by enrolling in an RN-to-MSN program. You might even be able to get tuition assistance if you continue your nursing education after you become an RN.

For now, you can still choose your own nursing education adventure – so choose wisely!

-Robyn Tellefsen

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