The Importance of the Baccalaureate Degree in Nursing Education

There are three educational pathways one may follow to become a registered nurse. The first is a three-year diploma program; another is an associate degree, most often offered by a community college; the last is a four-year baccalaureate degree offered at four-year colleges and universities. Methodist College of Nursing (MCON) is an example of a baccalaureate degree program. The baccalaureate degree earned is the Bachelor of Science in Nursing (BSN). Presently, the greatest number of nurses graduate from associate-degree programs (59%), followed by baccalaureate programs (37%), and then diploma programs (4%). Graduates of all three programs sit for the same NCLEX-RN licensing examination.
These various entry levels into nursing practice have been the topic of discussion within the nursing profession for many years. In 1965, after a three-year study, the American Nurses Association (ANA) issued “A Position Paper on Education Preparation for Nurse Practitioners and Assistants to Nurses.” The paper stated, in part, that “the education of all those who are licensed to practice nursing should take place in institutions of higher education” and “minimum preparation for beginning professional nursing practice at the present time should be baccalaureate degree education in nursing.” While many groups within and related to nursing support this position, the three educational pathways to registered nursing still exist.
Education Makes a Difference
Over the past several years, policymakers, researchers and practice leaders have identified that education does make a difference in how nurses practice. The baccalaureate nursing program includes all of the content in the diploma and associate-degree programs, plus it provides students with a more in-depth study of the physical and social sciences, nursing research, nursing leadership and management, community and public health nursing, and the humanities. This broader and more in-depth education enhances the student’s professional development and allows the baccalaureate graduate to better understand the many social, cultural, economic and political issues that impact patients and influence healthcare.
Several studies have demonstrated an inverse relationship between the proportion of BSN nurses and mortality of the hospitalized patient. In other words, they found that as the proportion of baccalaureate-degree registered nurses increased in hospitals, patient deaths decreased. These studies demonstrate that lower levels of patient mortality are associated with the nurses’ education levels.
Nursing education is also associated with patient safety and quality of care. In Claire Fagin’s “When Care Becomes a Burden: Diminishing Access to Adequate Nursing,” it was recommended that, in response to the greater acuity of hospital patients, the numbers of nursing schools in community colleges and hospitals be decreased while the capacity in baccalaureate degree and graduate programs be increased.
Many groups such as the federal government, the military, nurse executives, healthcare foundations, nursing organizations and various practice settings advocate for an increase in number of BSN nurses in all clinical settings. The U.S. Army, Navy and Air Force require the baccalaureate degree for active duty as a registered nurse, and the U.S. Public Health Service requires the baccalaureate degree in nursing for a nurse to be a commissioned officer. A nationwide Harris poll conducted in 1999 found that 76 percent of the public believe nurses should have four or more years of post-high-school education to practice. Many countries, like Canada, Sweden, Portugal, Brazil, Iceland, Korea, Greece and the Philippines already require a four-year undergraduate degree to practice nursing.
Economy and Expediency Should Not Influence Education
It is clear that education influences nursing care. The argument is often made that the associate degree costs less and takes less time to complete. However, economy and expediency should not influence nursing education, and ultimately, patient care outcomes. It is more costly and there is more time involved if one first receives the associate degree in nursing and then goes on for the baccalaureate degree. The associate degree takes two to three years and the baccalaureate degree two to three years beyond that. Therefore, the individual will take four to six years for a Bachelor of Science in Nursing degree. In addition, many associate-degree graduates find it difficult to return to school due to work and life constraints, as well as simply being “out too long.” Research supports the importance of baccalaureate education for the registered nurse in relation to positive patient outcomes. The state nursing associations for New York and New Jersey have introduced “BSN-in-10” proposals to require the baccalaureate degree for all registered nurses within 10 years of graduation from an entry level RN program.
While many argue that the associate-degree nursing education produces more registered nurses for our communities in a shorter time period, this should not be the primary focus, nor should cost of education. The baccalaureate-educated nurse brings a more comprehensive and in-depth education to the healthcare arena than the associate-degree or diploma nurse.
Research has begun to show the importance of the baccalaureate education in relation to patient outcomes; however, nurses still remain the least educated of all health professionals. Yet it is the nurse who provides almost all direct patient care in hospitals and many other healthcare settings. We require the teachers who educate our children to have a minimum of a baccalaureate degree. Why then would we settle for less education for the nurses who provide the care to our loved ones during the most vulnerable times of their lives? iBi
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Comments
Wholeheartedly agree
Baccalaureate Degrees are of cruical importance
Baccalaureate Degrees and Nursing
you know the biggest
you know the biggest complaint from nurses and other educated persons who hold higher degrees (masters and above) is that the two year degrees are cheap and are not educated as well as a baccalaureate in nursing, now i admit there are some shortfalls but to me this whole uproar for every nurse to be a baccalaureate nurse upon graduation is shortsighted and foolish, 58.4% of nurses in 2007 were associate degrees instead of requiring every nurse to be a baccalaureate upon graduation restrict where they can work and require them to go back to school instead of causing more problems in healthcare or feed the greedy colleges why do you think there is such a push for people to have baccalaureate degrees? money anybody?
LPN, ASN, BSN
As an Army LPN I can tell you that having different levels of nursing actually makes more sense do to the chronic shortages in the profession. Yes, education is important, but you can utilize your "less educated" nurses in lower acuity settings and still allow patients to have excellent health care. The LPN functions as your low-level workhorse in the medical-surgical setting and can typically manage 6-7 patients without any problems freeing up the 2-year RNs so they can deal with the higher acuity patients. BSNs serve best in the charge nurse/ward master/team leader or intensive care setting where they can take advantage of their higher education to coordinate their less-educated counterparts or deal with the highest acuity patients. Take away your LPNs and 2-year RNs and your BSNs are going to have 30-40 patients each - How well is their higher education going to help them with that situation?
quantify
Could you substantiate using figures; by what percentage did mortality and other health indicators improve by having Degree nurses in acute care settings.
thanks
BSN
Until nurses have BSNs there will continue to be low self-esteem, constant craving for recognition from others, sub-optimal acknowledgement of peer status in every way. Why can't we get this?
Pfffft.
Yeah. Right. Whatever. That's nice. Nursing shortage? I don't care. I've been working at all my prerequisites and I'm getting straight A's... but... Economy and Expediencey? You're joking, right?
After I finish my baselines, I have to wait 1 year until I can even apply for the RN program.
I've heard the waiting list of 1+ years? Excuse me intelligent persons, but if there's a "critical shortage in nurses"... why are you keeping prospective nurses on hold...?
It takes 1-2 years to complete the RN program.
That's 3-4 years and now you want me to add an additional 2 years onto that? To get my Bachelor's? And it might even take me longer cuz who knows, maybe the University I go to doesn't accept my college's credits and they make me take courses over so they can make more money off of me...
Hah, no thank you! :) I'm changing my major to something a little more expedient. If there's a shortage of nurses, I'm sorry but that is entirely your problem - I tried to help. You wouldn't let me. Now go deal with it.
education vs experience
I am just asking this question : Would you rather be in a plane whose plane whose pilot has few months of flight and tons of education or with a very experienced one with decent training? I have a lot of (foreign) education myself but i find that old fashion rn are more knowledgeable than bsn/msn nurses
ADN Programs still needed
ADN programs were created during WWII to facilitate more nurses during a shortage. We are still in that shortage of RNs and therefore the rationale for ADN programs is still present.
diploma and proud of it
re: diploma and proud of it
I graduated with a diploma in 2008 and am so proud to have been part of that 4% of nurses with a nursing diploma. I had awesome teachers, 3 years of clinical in-hospital hands on experience, and feel that when I first got onto the floor (hospital) I was prepared. I was able to advance faster than other new grads who have the BSN or MSN degrees, and had been able to take on more responsibility than them as they were still trying to learn how to ex: put in IVs, manage 2-3 patients at a time on a 25 patient med-surg floor, etc. After 2 months, Charge nurse, and after 6 months on the floor I was precepting BSN/MSN new grads (some who had NEVER put in an IV, changed basic dressings, placed foley catheters, etc. in school!!!)
I believe that having an AWESOME preceptor helped me transition onto the floor. The hospital did not have a nurse residency program for new grads at the time. So it was the guidance that I had and being able to learn from experiences that helped me become a better nurse. I believe that it's up to a nurse residency program or designated preceptor to help "the minimally prepared nurse" to be the best nurse they can be, regardless of the BSN, ADN, or Diploma nurse.
Put BSN/MSN RN new grads on a unit and ADN/Diploma experienced RNs on another unit and let me know who's patients are better taken care of at the end of the shift. Every educated nurse (regardless of degree) has to pass the NCLEX & have experience. If the RN is a new grad, give them the opportunity to be in a residency (or give them a knowledgable mentor) until they are observably able to manage as a fully functioning RN. To associate patient mortality rates with whether the RN has an BSN, ADN, or Diploma ALONE is rediculous.
rediculous? That is why we
BSN vs ADN and Diploma grads
after reading all those comments, I believed that they all have made sense in in their claims, anyway they're all entitled to their own opinion. However i think this issue is more about the individual's will, capacity to learn and ability to deliver the best patient care regardless of the title whether a BSN, an AD or a diploma grad.
If they're really serious about getting 80% of the nursing workforce to be BSN in 2020, then stop the community colleges and hospitals from offering non-baccalaureate nursing courses effective immediately and just leave the BSN mandatory to the current and/or future nursing students starting hereof.
Taking a nursing course is not cheap and easy. Economy and expediency would always be a factor of influence that affect the capacity of the individual to complete the course or not. But I got the point that if that individual wanted to pursue a more prestigious career and ultimately a brighter future, then he or she should do everything there is to achieve it.
And it won't be easy for those non-BSN nurses to go back to school and again spend time and money for a baccalaureate degree unless they want to aim for a more prestigious title and ultimately a brighter tomorrow.
fellow citizen think positively. at least in the US, when you get your degree, you are automatically guaranteed of a promising nursing profession.
In some countries that only mandates BSN degree to be recognized as a nurse, like here in the Philippines, not only that Nursing course cost a fortune... but the academic and clinical requirements are so high and taxing but after graduation, even after passing the state board, there's no guaranteed job available for nurses. So some of these poor fellows ended up in call center jobs, others at warehouses, salesperson in department stores, school office personnel and all other non-patient care type of jobs.
Worst, for them to gain experience after passing the board, they have to pay the hospitals or any medical clinics just to let them work and practice what they have finished, of couse without pay.
Based on HRSA 2008 statistics, almost 49% of the non-U.S. initial nursing education for US RN population came from the Philippines. That was the reason why BSN course became popular in the Philippines, until for some reason, the demands slowed down.
I hope the same Nursing organizations and associations who push for the BSN degree among the nursing workforce in the U.S. can do something too to accomodate these competent but unfortunate BSNs in the Philippines. There are more opportunity to improve the nursing practice, not only the States but in the global context of patient care as well.
Anyways, Nursing care is supposed to be universal and not bound by any barriers, be it distance ,culture or language, in caring human being.
thank you for reading my letter this far..
Diploma vs BSBI graduated
Diploma vs BSB
I graduated from a state university with a BS in biophysics with no skills other then how to take a multiple choice exams and am about to graduate from an 18 mo diploma RN program and I am managing/holding down the whole floor with 3 other classmates. To me it looks like a case of big universities seeing that more ppl are looking for real life skills that will get them jobs no offense to all you humanities majors out there. My school opened in the late 1800's. Back in those days nursing students started their day scrubbing floors and changing beds. What's next a BS in welding? Common sense and tons of practice is what makes a good nurse. And trust me, you arent getting much practice sitting in an emphatheater staring at a PowerPoint.
Nursing Shortage
I'm reading all of the comments about a nursing shortage, but I want to know where this nursing shortage is? I live on the east coast (mid-Atlantic area) and there is no nursing shortage here. I know some nurses where it takes well over a year to get a job. If you have your bachelors, you have a better shot, as most hospitals around here are requiring that now.
That is why if you want to
Perhaps going for a BSN is
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