Why an ADN looks like the new LPN for nurses

blood-pressure-cuffOne of my close friends recently sent me a picture of the current textbook she was reading for her first class working towards her Bachelor of Science in Nursing (BSN) from her RN.

As I read the excerpt from her book, I was offended. The part that upset me discusses the “‘never-ending fracas’ over the varying credentials for entry into nursing practice as contributing to the continuing subordination of nursing in the health care arena. Nursing’s lack of a standardized requirement for a minimum of a BSN, and preferably a master’s degree, stands in sharp contrast with other health professions requiring more education to practice” (Black, 2014). There is something to be said about this. It’s a perplexing subject. Should the minimum requirement for RN’s be a Bachelor’s degree?

I graduated with my Associate’s degree of Nursing (ADN) and worked as a nurse for almost five years before completing the bridge to my BSN. I can honestly say that it was a “BS” degree, bringing no added value to my practice as a nurse.

The core nursing classes are taken for your Associate’s degree. This is where you learn to critically think and apply the information you’ve learned to clinical application. While acquiring my BSN I did not learn anything that made me more experienced than the associate nurse. The most I can say is that I’ve learned to write a research paper, understand public health more, know more about nursing leadership, and have a greater understanding of topics including pathopharmacology and health promotion.

The majority of the classes that separate an ADN from a BSN are classes that don’t really pertain to those who work bedside. So why is there such a push for nurses to attain higher education?

The sad part is it appears that the ADN and diploma nurses are going to be phased out over time from hospitals, the same way many hospitals started to decrease or stop hiring Licensed Practical Nurses (LPN). Some states have tried to enact a BSN-in-10 legislation that would require RN’s to earn their bachelor’s degree within 10 years of initial licensure.

While researching this subject I came across the following and have honestly shaken my head in wonder, “the baccalaureate is becoming the preferred degree for bedside nursing care in many hospitals, in part because the health care delivery environment has become more complex and in part because tomorrow’s older patients will be sicker and require more complex care” (Ladden, 2013).

This is very interesting, because in the same paper they acknowledge that AD nurses get an “excellent clinical experience,” and their “education has been heavily skills oriented and focused on acute care” (Ladden, 2013)

So if the AD nurse has an education that is focused on clinical skills and acute care, then why aren’t they equipped to handle patients bedside in the same manor as those who have their BSN? There is no reason they can’t, except there is a requirement for the number of nurses who have their BSN when it comes to hospitals reaching Magnet Status. Is the push for Magnet status at many facilities leading to the increase demand for nurses to obtain their BSN?

Nurses are amazing on all levels. When it comes to it, we should all strive to continue to learn and obtain higher degrees… However, it should not be a requirement. In an Associate’s program nurses do learn everything they need to know to be a great bedside nurse and provide the best patient care possible.

I can understand the desire for nurse leaders to obtain their BSN, seeing that it does encompass classes that pertain to leadership. Also, nurses who work in public health or who develop evidence based practices should have higher degrees. Nevertheless, it seems asinine for a text book educating nurses to suggest that we should all at least obtain a BSN, and preferably a MSN.

The nursing profession is one of the most well known and TRUSTED professions in the world, most people don’t even know the difference between the education levels of nurses. If we want to become more professional, we need to educate nurses on ways to become better involved in the political aspects of medicine that directly affect the patients and nurses (i.e. CMS reimbursement and patient experience reimbursement). Debating the merits of higher degrees as pertaining to one’s ability to provide proper bedside care debases the nursing community as a whole, and drives us away from a more productive conversation about the profession.

Black, B., & Chitty, K. (2014). Professional nursing: Concepts & challenges (7th ed.). St. Louis, Mo.: Elsevier.

Ladden, M. (Ed.). (2013, September 1). Charting Nursing’s Future Reports on Policies that Can Transform Patient Care. Retrieved April 5, 2015, from http://www.rwjf.org/content/dam/farm/reports/issue_briefs/2013/rwjf407597

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