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ADVANCE Perspective: Nurses

BSN-Go-Round: Will profession finally grab brass ring on upgrading education standards?

Published January 17, 2012 11:02 AM by Guest Blogger

Kay Bensing, MA, RN, is senior staff nurse consultant at ADVANCE.

Recently, I talked to an editor on the ADVANCE staff who was excited about a program that aims to meet the elusive goal the American Nurses Association proposed in its famed 1965 position paper: requiring a BSN as the entry level of RN preparation.

A diploma graduate of 1965, I was still 2 weeks away from receiving my RN license when the paper was published. Then living with several of my nursing school classmates, the thought of us returning to school for a BSN was out of the question. We were dedicated to practice nursing and learn every day - but we also had other priorities. After all, nursing school had not been a picnic. We needed some freedom from the books for a while.

It took less than a year for my colleagues and I to recognize our solid nursing education background was serving us well, but we wanted to learn more and extend our nursing opportunities. It wasn't long before we were enrolled in bachelor's programs.

Much of my career has been spent in academic and continuing education. I always advocated to nursing students and practicing nurses the value of advanced nursing education, along with the reality of personal and family sacrifices.

While at ADVANCE as senior staff nurse consultant, I've written many times about the need for nurses to further their education. Reader responses varied; I was either preaching to the choir or taking on nurses who told me they didn't need more education to prove they provided compassionate care.

Fast forward to a few weeks ago, when the editor was excited the time was right for the tide to turn - more nurses getting their BSNs. I replied, with a dismissive and defeatist comment, "I don't think I'll see the day in my lifetime."

On Dec. 6, 2011, the American Association of Colleges of Nursing (AACN) released the results of its preliminary, annual survey related to RN educational levels. The results were impressive: From the data reported from 647 of 840 schools surveyed, all RN programs grew from 2010 to 2011, including 3.9 percent increase in generic BSN programs. In BSN completion programs, the increase was 13.4 percent.

"With the Institute of Medicine and other leading authorities calling for significant increases in the number of nurses with baccalaureate and graduate degrees, moving to prepare a more highly educated nursing workforce has become a national priority," said AACN President Kathleen Potempa, PhD, RN, FAAN.

Going on 50 years after the original ANA initiative, the AACN report does seem like a belated gift to nursing. Let's keep the ball rolling.


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I have been an RN for 22 years. I am 60 years old and at the end of my career. I have been working as an RN with an ADN degree as a Flight Nurse, Burn Trauma ICU, and currently Hospital Supervisor at two hospitals. I have had outstanding evaluations and am now being forced to go back and obtain a BSN degree which is creating a hardship on my family and myself. Financially and time with children who need their mother. This is morally WRONG to impose such a hardship on a PROTECTED GROUP (over 50)! I feel defeat, anxiety, sleep deprivation and BULLIED into this situation which I did not plan for in my life. It is so very wrong to not grandfather this protected group into this category until we're gone. I have had an amazing career, but this has made me angry and bitter toward nursing "authorities"! At this point, a stupid BSN degree helps NO ONE! It will NOT make me a better nurse or care for patients better than I do right now........ OR EVER! Very mean spirited. I am a person, with a life, and it's being ruined. Not to mention ruining personal relationships because of time lost with loved ones. Oh, that's right..... i'm just a number to make someone else look good. LET IT GO!!!!!!!!!!

Donna Mills, Hospital Supervisor - RN, Hospital January 4, 2017 7:10 AM
Salt Lake City UT

I took the liberty of researching the IOM (Institute of Medicine).  Surprise, surprise; just about every one of its officers and board members are in some way affiliated with a four year college or university.  It is no wonder they're calling for increases in the number of nurses with baccalaureate and graduate degrees.

Now let's have a little quiz NCLEX style.  There may be more than one correct answer.  Choose the one that is most correct.

Who benefits the most by nurses having to run back to school for BSN and graduate degrees?

A.  The patient who is now being cared for by a BSN who wrote a few more papers on current issues and nursing theory but received no more clinical education or hands-on training.

B.  The now debt-ridden nurse who is still making the same amount of money they were before the BSN.

C.  The four year colleges and universities.

D.  The student loan lenders.  

Peter DiGiuseppe, RN April 17, 2012 2:08 PM

Dear Advanced For Nurses,

I have read many well written and well thought out comments with regard to the BSN debate.   Every single comment has a point and drives home the message that the degree is not the nurse.  The nurse is the nurse regardless of her educational status or degree.    We all went to nursing school (or college) to learn how to do what we love to do – take care of patients.    As we hone our skills, we moved on in our career and take those skills right along with us.    Some of us went onto pursue further degrees while others remained working just as hard right along side us.    

I agree that education is a wonderful part of life.  It enriches us as nurses and may even allow us to converse more professionally with our colleagues, peers, doctors, but most importantly, our patients.   I’ve spent my life going to school part-time to obtain advanced degrees, but to this day, I do not feel it has made me a better nurse.   I’ve always been a good nurse.  

As nurses are aging gracefully, I would find it impractical for those RNs to return to school to obtain a baccalaureate degree only to retire upon graduation.    If this is something that some states, hospitals or future employers will press for, they should consider grandfathering those nurses who have a defined number of years of experience.  In addition to grandfathering a subset of these RNs, thought should also be given to the ramifications of the additional cost incurred by those nurses who may not be able, either due to family or financial obligations, to return to obtain that degree.  What will become of them?  

A rose by any other name is still a rose.   The same applies to Nurses.    Good luck with this debate.  

Joann Geslak, RN BS MBA CNOR

Joann, Surgery - RN, Director, Central Maine Medical Center February 10, 2012 5:16 PM
Turner ME

If I hear one more time that BSN nurses are more educated than ADN nurses, I am going to scream. I am proud to say that I am an ADN nurse--my diploma hangs proudly on my wall. I have been a nurse for nearly 6 years now, and decided on my terms that I will go back and obtain my BSN. Many BSN nurses I have talked to have told me that recruiters told them that they would make more money than the ADN nurses...they were shocked to find out that we make the same amount of money. The only way I will make more money with my BSN is if I decide to go into management...I say you can keep it!!! To be quite honest, the only reason why I am going back to school to obtain my BSN is to become a NP-yeah I said it!!! With the ecomony as sluggish as it is, many students are rediscovering the community college and obtaining their ADN-no one can afford the ever increasing cost of a 4 year institution. Besides, if this debate continues, you will divide a nurses station quicker than anything with such talk as who is the most educated!!!

Candace Talley, med/surg - RN February 9, 2012 2:32 PM
Knoxville TN

BSN mandated? No way.  I know we would lose many, many nurses, those who cannot return to school for numerous reasons. While I believe that continuing education should be a must, perhaps using that education to hone and perfect your hand-on skills related to  direct patient care should be the focus. Not theory. I am back in school currently, and frankly wish I wasn't and actually have considered withdrawling. The schools are dropping the ball with furthering education for nurses- I really have to start over, from the very beginning. I am degraded in class because, and I quote, "Being an LPN is fine, good that you have done a little health care". I've been in nursing in some capacity for nearly 25 years! Why would anyone want to go back? I love my patients, I love doing the job I do. I have helped train the new BSN's on the floor, and countless times am told, "I have never done that", related to catheters, G-tubes, IV's, dressing changes, breath sounds. Really? I came from a diploma program, and am here to tell you, we spend a great deal of time learning hands on everything- with real patients. Our instructors hunted down procedures. Theory should never trump patient safety. EVER. I have furthered my own education by reading, attending seminars, and acquiring new certifications related to my field. Never stop learning. But perhaps the view has been skewered. As nurses we know what is ultimately important, and it is time that we stop listening to what the corporations and educational institutions are saying, and go with what we know.

Christine, LTC/SNF - LPN/WCC February 5, 2012 8:35 PM

I am Diploma graduate from 1974 and very proud of it. While in nsg school I was selected to enter the Navy Nurse Candidate Corp with a scholarship and was promoted twice before receiving an honorable discharge. I was a naval officer for over 5 years when I married and had a child.

From there I worked part time in a small private hospital in their adult ICU while caring for my child.

I got divorced and moved to a university town where I worked full time for 27 years in their adult ICU's and as an Adult ICU Transport Nurse and am now semi retired. I went back to work for that hospital as an Adult Rapid Response Consult Nurse making proactive nsg rounds and have helped invent and nurture this role.

For more than 20 years I have been a CCRN and active in our chapter. I have been an ACLS intructor for 15 years and now a CFCN-Certified Foot Care Nurse which is under the WOCN specialty and cut adults toenails per MD orders.

I have been published 3 times in nsg magazines and had a poster presented at the NTI as a CCRN.

In 2005 I was selected as a Great 100 Nurse in NC.

I do not have a BSN. I have never felt the need to get this credenital as I am an independent thinker and self motivated.

Thank you for this opportunity to express myself.

Janice, Adult Rapid Response - RN, UNC February 5, 2012 3:22 PM
Chapel Hill NC

All of my life I knew I wanted to be a nurse. Unfortunately after high school I didn't go straight into Nursing school and then life just happened. I got married and had two children. Facing a dead end job, divorce and no real way of earning income to raise my daughters I decided to get my RN. I started getting my pre-req's at the local community college and transitioned into their Associate Degree RN program. I will admit that I looked into the local univeristy BSN program but decided against it when I realized there was no money difference between Associates Degree and Bachelor's Degree. I needed to be done with school as soon as possible and had no desire to spend extra time in school learning how to "push papers and take a step towards being a manager". Fast forward 8 years and here I am. I am a new NICU nurse with past experience in Med Surg./Oncology, Labor and Delivery and Maternal Newborn. I have thought numerous times about whether I want to obtain my BSN. The hospital I work at offers a program now but here's why I'm not interested.....

I have NO DESIRE to further my education and become a manager or teacher. I would never want to come away from bedside nursing. Managers who forget what it was like to work with the patients because they are so wrapped up in meetings and budget talks. Dictating how things need to operate because the "higher ups" told them that's how it needs to be.

I am certified in my field and go through yearly assessments and competencies. I always have stellar performance appraisals and am liked by my managers and coworkers. I know every night that I go to work I am giving my patient and family 100%....irregardless of how many initials I have behind my name.

Another reason I think mandating a BSN is inappropriate is that I had my chance. I did what I always wanted to do and that was become a nurse. Now it's my daughter's turn. I have one attending the same local community college that I attended with hopes of graduating the same RN program as me. I also have a sophmore in high school who hopes to graduate a year early and also do the same.  I save money for their college not mine.

I agree the higher you intend to pursue your field then the higher your education should be but being a bedside nurse is not about the initials, it's about the heart and passion of what you do everytime you clock in and greet your first patient.

Stephanie Horeth, NICU - RNC February 2, 2012 1:47 PM
Virginia Beach VA

Thank you Leslie.  It's about time that the general public become informed.  If it's not about the money, why should it matter to academic elitists where a nurse graduated from as long as they are competent and professional.  They are dead set on closing excellent diploma programs because they represent a loss of revenue for 4 year colleges and universities.

Well, I am preparing to contact my local news stations about the truth behind the BSN and Magnet Status rackets which are two of the biggest scams perpetrated on the American public since the new and improved product scam of the 70s.  

I think most intelligent nurses agree with you that as far as a BSN goes, the first two initials pretty much sum it up.  

Peter DiGiuseppe January 30, 2012 7:56 PM

I've investigated going back for a BSN.   But what I've found is that it's particularly heavy on the first two initials and light on the last one.  

Ok, I'll admit it looks really cool for a hospital to say "all our nurses have their BSN."   YAWN!!!  Does that make them more competent nurses?  No.  Does that make them more compassionate nurses?  No.  Do the added classes in research and report writing further their clinical skills?  No.  Is a nurse with a BSN a better nurse than a nurse with an ADN.  Maybe but that would depend on the individual.

Ok then why the push other than to A) appease hospitals so they can brag about something that adds no value but sounds really cool to the uninformed; and B) pad the pockets of four year universities while forcing students to pay more in tuition than they would at a community college, and take more courses that really don't impact patient care?

With all the uncertainty in the healthcare industry surrounding the recent healthcare "reform" legislation, surely the legislators can think of something better to do with their time.

Leslie Hillhouse January 30, 2012 6:34 PM

I graduated with my first degree, a Bachelor of Arts in Interdisciplinary Studies, in the late '70's. Basically it was just a liberal arts degree. In 1980 I went back to get my ADN and have practiced as a staff/floor nurse for 30 years. When I first went to work in a hospital I was able to see the ADN students and BSN students doing their clinicals in the hospital setting and the biggest thing I noticed was the ADNs were out on the floor actually TOUCHING the patients. They were putting in foleys, ng tubes, starting IV's, doing dressing changes, suctioning and changeing out trachs, working with colostomies just like I had done in my ADN program. The BSN students walked around and looked at the patients, holding their textbooks in their arms.  Today the BSN students who have started on our unit have never done any hands on patient care. It is up to us, the ones who don't have the BSN or some of the LPN's to teach them on the job how to do the real hands on things that surgical patients require. I don't understand how someone can come out of college (and keep in mind I am a 4 year college graduate) and not be able to have hands on knowledge regarding nursing care and what is required on the floor. I am aware that even though one has had the practice on the unit during school that it can still be frightening once you are out there on your own. But it boggles my mind that states are wanting to force nurses to start out with a BSN, that is unless the colleges and universities are also going to have those students have actual physical contact with patients while they are in school. I was shocked a few weeks ago when one of our new BSN Rn's didn't know how to give a Fleets enema.  I understand that part of being a nurse is education but I have to agree with others on here that the most important part of nursing is our interaction with the patient and a large part of that comes, not from books, but from hands on experience. If BSN's can come out of school with some hands on experience during their education then I have no problem with this legislation. I also agree with the writer below who stated that if a nurse had a previous bachelors degree that it should be taken into account. Mostly though,the  reasons I never went back to advance my nursing degree are because I wanted to be with my family and had no desire to be a nurse who sat behind a desk all day. I wanted to actually take care of patients...hands on.

Wyche, med/surg - RN, vamc January 30, 2012 6:12 PM
Augusta GA

I started as an LVN for many years largely because I couldn't afford the BSN program and the LVN degree enabled me to earn income while I also went back to school to complete my BSN. I've spent most of my 16 years on nursing working in the Texas Medical Center in Houston. I have seen exceptional LVN's and ADN's and inferior BSN and MSN's. Experience is by far the greatest attribute to developing a great nurse. HOWEVER - having said that even the best of experience is limited to the foundation on which it grows. The why's of what we do are integral parts of our ability to understand the medical process as a whole and the care we provide. We are often in the best position to evaluate new or unexpected responses to treatment that could easily be overlooked with inadequate training. I strongly feel BSN should be the entry level of required education for those of us who are trusted w the lives of our dear patients.

Holly Raymond, Oncology - RN January 30, 2012 5:30 PM
Houston TX

When I was earning my business degree in the late 80s, years before I went to nursing school, I very wise professor admitted that most four year college degrees are bloated with so much useless nonsense that has no real world value.  

I am looking over the curriculum for BSN and MSN Programs right now. What I'm seeing are courses such as: Theoretical Foundations for Nursing, Leadership in Nursing, Professional Ethics, Research Methods and Current Issues in Nursing. I'm sure these are all fine courses for those who wish to go into advanced nursing degree  programs. But I reiterate, They will not make one a better nurse.  I've already stated where the ability to use critical thinking in nursing situations comes from; certainly not from any RN- BSN  Program or writing more papers but from experience and working with clinicians with much more experience who are willing to train and mentor.

Americans are being sold this higher degree bill of goods with the only beneficiaries being the colleges and universities as well as the loan lenders who get the interest from the loan repayments.  

The problem for nurses is that many mindless, unthinking nurse recruiters are easily influenced and are buying into this BSN scam.  And yes, it is a scam.  The general public needs to be made aware that they will not receive better treatment by hospitals who only want to staff their floors with BSN nurses.  As a matter-of-fact, many of our most skilled and experienced nurses have said they would leave the profession if they are forced to spend thousands of dollars on something that will not make them a better nurse.  These are the nurses that you and I would want to have taking care of us.  To lose these nurses would be a danger to the general public.   I am planning to contact local news programs to see if they would be interested in this story from a nurse's perspective.  

Kudos to MD in PA who said; "Put an advanced-degreed nurse manager on a floor with a slot of 10 patients and you will really see patient mortality rates increase!"

P.S. To  all you nurse recruiters who may now try to blacklist me; I'm only going to work that much harder to get this point through to the general masses.

Peter DiGiuseppe January 30, 2012 2:32 AM
Philadelphia PA

I think education is very important I have had my C.C.R.N. for 24 years and have been a R.N. for 30 years. Obtaining a B.S.N. is a wonderful goal but in the current state of recession that the country is in this would place undue hardship on too many nurses.

Christine January 29, 2012 4:43 PM
Gainesville FL

I have been a nurse for 34 years ,I have an Ass. Degree. I would like to retire in 10 years. What purpose would a BSN serve for me ,except a school loan and finding a job to pay that loan back ? Could I retire then ? Would it make me a better Nurse ?

If I had it to do all over again ,BSN would have been the answer,there are nurses who don't have jobs and are trying to pay back school loans ? Grandfathering in older nurses seems to be a good plan,I don't think it will happen!!

Suzanne Plaza, SSU-Pacu-GI - RN, TANNER Health Systems January 29, 2012 11:34 AM
Carrollton GA

We need to mandate one entry level into practice. In 1970 I was a student in a vocational/technical school LPN program. Our instructor taught about the 1965 position paper requiring a BSN by 1985 for entry into professional practice. She instilled the idea of a professional education by her coaching and example.

As a graduate of an LPN school, RN AD and a BSN program, I can say from experience that I didn’t understand my role as a professional nurse until BSN education. BSN curriculum increased my knowledge and empowered me to develop self-awareness and critical thinking. A BSN transformed me and prepared me for professional practice.

Nursing requires well-educated, disciplined and dedicated people who work by the highest standards. However, despite ANA’s position toward Baccalaureate education as the foundation for professional nursing practice, here we are in 2012 still shooting ourselves in the foot.

Mary Ellen, Primary Care - Supervisor, NF/SG/VHS January 29, 2012 9:31 AM
The Villages FL

We need to mandate one entry level into practice. I was a student LPN in 1970 and was taught about the 1965 position paper requiring a BSN by 1985 for entry into practice. Despite ANA’s position toward Baccalaureate education as the foundation for professional nursing practice, here we are in 2012 still shooting ourselves in the foot.

As a graduate of an LPN school, RN AD and a BSN program, I can say from experience that I didn’t understand my role as a professional nurse until BSN education. BSN curriculum increased my knowledge and empowered me to develop self-awareness and critical thinking. A BSN transformed me and prepared me for professional practice.

Nursing requires well-educated, disciplined and dedicated people who work by the highest standards

Mary Ellen Pelkey, , BSN,RN,BC NF/SGVHS January 28, 2012 7:32 PM
The Villages FL

I am definitely for a BSN for entry level into nursing.  I graduated in 1972 from a Boston teaching hospital and was fortunate enough to have all clinical rotations in Harvard teaching hospital.We were also fulltime students at the local university our freshman year.  We got into the hospital for clinical in the first 6 weeks.  We went year round, no summer break!!  Make no mistake as our experience continued we were counted on to staff these units.  It was great clinical experience under someone else's license!!  We were encouraged to build on our college credits and work towards a BSN which the trends of nursing course predicted would be the entry level for RN positions.  I did just that as a married, working mother of 2 babies at the time slowly worked towards that goal.  I had been an RN for 10 years at the time I earned my BSN.  At that time there was no such thing as online courses-you showed up to the brick and mortar building or no credit.

    Well, here it is almost 40 years later and I am approaching retirement and nursing is still having the same debate.  I am very disappointed that my profession still does not have a single standard for entry of a BSN.

    i worked for 38 years as a clinical nurse in several Boston teaching hospitals.  I worked with hundreds of nurses and as time went on most of them were BSN prepared.  I found them to be very bright and quick learners.

    I have recently moved to a warmer climate in Florida and I am still working as a RN, but not in a hospital.  I have been shocked by the clinical areas in Florida that have replaced RN's with LPN"S , MA's or Paramedics.  I hope this is not a national trend to save money because it has been my personal experience that this is sub-standard care.

Cheryl, Pediatrics - RN, PSA Healthcare January 28, 2012 4:37 PM
Melbourne FL

I graduated with a ADN.  I worked to get pre-reqs for the BSN and had to move due to my husbands job.  Educating children along the way and getting everyone through college.  My husband then went back for his masters.  I would love to have gotten a BSN or counseling degree but the years slip by.  Education is always beneficial!  So, at age 59, working full time 12 hour shifts, driving one hour one way to work and living in the country. Please someone find me the lease expensive but good online program so that I can finish my BSN. (We are still paying off student loans)  Really, if anyone knows of a good program online anywhere let me know.  Most that I have researched are too expensive and it does not make any sense for me to enroll as it will not change my salary enough to matter.  Thank you.  And Yes, some of the best nurses that have a great work ethic are ADN and diploma but perhaps it is the generation.

Christine Dalecki, Correctional Managed Care - staff nurse, Estelle January 27, 2012 9:52 AM
Huntsville TX

I agree that obtaining a BSN is expensive and takes time to achieve the goal. However the benefits of this educational experience are more than beneficial, they are essential to a successful nursing career in the year 2012. Most other disciplines view a baccalaureate degree as the basic entry level into a discipline. Nursing must embrace these changes to keep up with advances in medicine and elevated standards of  nursing around the world. Europe, England, Ireland and Australia mandated many years ago that a BSN is the entry level into nursing. Considering we have one of the most advanced health care delivery systems in the world, the USA should move forward and catch up with nursing colleagues across the globe. This would elevate nursing to a different level, perhaps one where we receive more respect and recognition for nursing as a profession as opposed to the current image television portrays as a flirtatious female wearing a short white uniform and frilly cap.

Anne, School Nursing - Administrator School Health Program, Health Care District of Palm Beach County January 26, 2012 8:33 AM
Palm Beach County FL

I graduated from a Diploma Nursing School in 1984,

I have held  positions  that had " BSN preferred"  on the  qualifications  because of my  extensive background.

I think  the nurses who are very pro- the  BSN in  10  for everyone,   need  to use the  compassion  people in  this  career are  supposed to  have and  realize that   not everyone who is a  RN  has what they  have available to them. The finances, the ability health wise  or  both .

I work per diem as a home care  case manager in the field.

I  work per diem because i have  fibromyalgia. I treat this in non  pharmaceutical ways and i walk a fine line  to keep myself healthy , to take care of my family and my clients, who are like a  second family to me .  

A  RN to BSN online  would cost me  at least 28,000 - that is equal to or more  than my income  after taxes in a year.

Money that  should be going towards my children's education  where it may actually make a difference in future income for someone.

And how will that BSN  make me a better nurse for my patients ?? It wont . I will be the same  exact nurse with the same  exact experiences, compassion and  love for my job that my clients recognize and  is the reason  why they come back  to the agency I work for , requesting me to be their CM again .

Being  required  to get a  BSN  will not only  stress me financially , it will stress me physically -possibly enough so that I would be back where I was with my FMS 7 years ago and too sick to work .

For me, and I am sure many others the  RN in 10 idea will become   RN on disability because we decided 3 letters were more important then 27 years experience .........

I don't  expect to be given a  free  grandfathered  BSN  or  positions that require  BSN by the company -- but I do deserve to be able to continue to  work in a profession I love and receive the  respect I deserve, from my professional  community  for the experiences I  have .

Debra Ezekiel, Home Care - RN Case Manager January 25, 2012 3:00 PM
audubon NJ

I agree with many comments here againts mandatory BSN degrees for nurses.  We are facing the largest generational die off in the history of America as my generation of Boomers start passing away.  The nursing shortage is expected to rise sharply over the next five years - precisely the time when nurses will be most needed.  In Pennsylvania, we've gone from over 75 diploma schools in the early 1980's, to about 16.  The trend is the same nationally thereby exacerbating the degree of the nursing shortage.  The cost effect of requiring a BSN degree to practice nursing is prohibitive.  My schools program costs about $30,000 in total and takes three years.  BSN programs run over $100,000 and take four years to finish with no discernible effect on competency or patient outcomes.  Why?  What sense does it make to force students to pay three times as much for a BSN when they get the same credentials, pass the same licensure, and have the same clinical expertise at the end of the process?  Sure sounds like degree creep to me - very expensive degree creep!

feudi pandola, Finance - Financial Aid Officer, Nursing school January 25, 2012 1:33 PM
Philadelphia PA

Dear Fellow Nurses,

I couldn't agree more with Kim Troutman and I could not have said anything better than that! I strongly feel that I have earned the "grandfathered" BSN because I have been working in critical care for 18 years, I am certified CCRN AND CSC with AACN. I work four 12 hour shifts a week, not because I want to but because it is a critical need at our hospital. If I was forced to go back to school for my BSN at this time in my life I would have no personal life what so ever!!

The only people that would benefit from my continued college work would be the college itself! It is very expensive!!! So I would become more in debt and my salary would not increase!

My work expectations would not change! Nothing would change except my family would not see me at all, and I would owe a lot

of money to a college for a long time!!!

I have no  plans  to go any higher in the chain of command at my hospital. I plan to stay at the bedside doing what I do best until I physically can not do it any longer. Then I want to retire!

I know I have used a lot of !!!! in my blog but I am really upset!

I am really hoping this is alot of #%&*@# and I can relax and go back to stressing about dealing with doctors and families and not this stuff!!!

Thanks for letting me rant :-)

maureen mukhlis, CVICU - RN, Grand Strand Reg. Med. Cntr. January 24, 2012 5:16 PM
Myrtle Beach SC

Not every professional nurse needs to hold a degree.  We need to get back to basics and educate nurses to be nurses.  There is leadership in basic nursing education.  There is publis health in basic nursing education.  There is practical care and logic in basic nursing education.  A nursing diploma provided exceptional education on how to be an exceptional nurse.  And it didn't cost an arm and a leg to attain (often the students received a stipend).  Graduates of diploma programs were well versed in all aspects of nursing care when they graduated.  They understood the challenges of working shift work and they knew how to be in charge.

I don't need a BSN or an MSN, or a PhD to be a good, thoughtful, caring accomplished nurse.


Ima Nurse, IT - RN, BS, Maimonides Medical Center January 24, 2012 10:19 AM
Brooklyn NY

I am a diploma grad who went back to school at age 40 for a degree. I think the diploma and AD nurses should all be grandfathered in and radical changes made to nursing education. How about all nurses start out at the bottom and learn what nurses aides do, get certified in that, then learn what a practical nurse does, then a diploma nurse,  then on to the college liberal arts and leadership courses. We could get certified at each level and be employable while going on to further schooling. Then we would all be on the same page, with the same backround.

Sheila Boyle, OR January 23, 2012 5:57 PM

“I am a nurse.” For 22 years, I have uttered that phrase with unspeakable pride and joy. It is my essence as much as being a mother, daughter, sister, friend.  I am a diploma nurse from a premier Medical Center and have spent 19 of my years working in emergency medicine which is a fast paced, emotional and physically challenging field. I love what I do and I take great pride in being a high performer, keeping up with my certifications, maintaining respect with my colleagues and the doctors I work with.

In those 19 years, I have helped save countless lives, have held the hand of dying patients and helped them pass with dignity, have comforted grieving family members, have been assaulted by angry or under the influence patients, and have witnessed things that I will never forget because of the emotional impact.

I have had patients who have remarked to me, “I can tell you love what you do” and that has been the highest compliment to me because I do very much love what I do and I take pride in doing the best that I can. I can tell so much in the assessment of a patient by one glance and can get the care initiated that best serves that patient’s needs, that is what a good nurse does.

I am not alone in this; I work and have worked in many emergency departments with some of the finest nurses and they too take great pride in what they do and they come from all types of backgrounds; some are diploma nurses also, some are associates, and some are bachelor prepared. We all share a common goal no matter what our credentials say; we all want to provide the best, life-saving care possible, maintaining our patients dignity and respect.

We have all worked holidays, weekends, long hours and have missed countless events at our children’s school, sporting events; not because we don’t care but because we are nurses and we knew from the beginning that this was a sacrifice we would have to make. Our families understand that and we do the best we can to work with each other so we can make as many events as possible. The teamwork in nursing is an incredible thing to be part of. We are a family no matter what our credentials say.

This being said, we are now being told by our institutions that we must all have bachelor’s degrees within a certain amount of time or we will not be employed and all across the country there is a push by the American Nurses Association subsidiary, American Nurses Credentialing Center, ANCC, to have hospitals become Magnet certified.

They believe that hospitals seeking Magnet certification become premier institutions by retaining staff, attracting talent, improving patient satisfaction as well as RN satisfaction and advancing nursing practice. While this is a very worthwhile goal, I have to question what greater good will serve the public if every nurse is a BSN. Can a four year degree give you the love for what you do, or the desire to care for people or better take care of them?

What about those of us who have given so much to the profession and love what we do and do a great job without having the extra liberal arts, English, speech classes required for a degree? Why do we now have to spend thousands of dollars to go back and get our degrees while still working full time taking away even more time from our families and adding more stress to our lives? I have seen countless BSN students come out of their programs having never placed a foley catheter, or countless other skills because their focus was not on the clinical, or bedside nursing.

If you were a patient in an emergency department or on a medical-surgical  nursing floor, would you want a nurse who has a high degree or a nurse who has experience regardless of what a piece of paper states. Not a single patient has ever asked me if I have a bachelor’s degree; they were grateful for my care and my knowledge.

I am certainly not stating that BSN nurses don’t care or aren’t good nurses, on the contrary I have worked with many great BSN nurses including the greatest nurse I ever worked with who also precepted me at one institution. I just think that the politics by the ANA/ANCC are degrading to those of us who don’t have a BSN but still take pride in being a nurse and doing a great job.

I would think the push by ANA/ANCC would be to maintain high performing nurses of whatever degree they have or don’t have;  who have a desire to do their best by their patients and give 110% everytime they are at work. This in turn makes patient satisfaction higher because they are well taken care of which makes the hospital a better institution.

The bottom line should always, always be about giving the best care possible to our patients and that can be accomplished with nurses from all walks who may or may not have a higher degree. Patients will return to hospitals who have caring nurses and felt that their needs were met.

Don’t punish those of us who don’t have that special piece of paper by making us go further into debt to obtain it and take more time from our families. We want to continue to love what we do and care for our patients as we always have.

There is certainly nothing wrong with choosing to pursue a degree to progress up the ladder and take management or advanced nursing positions such as nurse practitioners; It should be our choice, not a mandate.

                                          Proud to be a diploma nurse,

        Kim Marie Troutman

Kim Troutman, Emergency Nursing - RN, Pinnacle Health January 23, 2012 3:12 PM

I agree with the idea of grandfathering RN's who have 10 years experience, experience is the best teacher.  I also think that since Associate prepared RN's or diploma RN's should take different boards than BSN's.  We all passed the exact same nursing boards but a 4 year degree is valued more?????? I'm not quite sure  that I understand that concept.

betty tompkins, Anticoagulation Therapy - RN, Our Lady of Lourdes Hospital January 23, 2012 11:32 AM
Binghamton NC

I'm a new nurse. I decided to change careers and went back to college at age 52. I had a stellar academic career, but since graduating in May 2009 I've only been able to scrape together a total of 3.5 months working experience in three short-term jobs, two of which were seasonal; my first job was dangerous and I very regretably resigned. Now approaching 60, I'm very fit and able, energetic, and determined. I'm also $20,000 in debt and after 6 years without a job, a financial black hole in the household: my magna *** laude BSN is doing nothing to get me a job. While some prospective employers see my life experience and professional non-nursing working experience as an advantage, those who get back to me after an interview (and they are few and far between) always cite my lack of experience as the deciding factor.

I can tell you that as a BSN prepared nurse, I did not feel confident in my clinical skills when I graduated. Clinical rotations did not provide enough exposure to the practice environment or opportunities for practice. It seems that no new nurse can hit the ground running, and in order to practuice safely, all require extensive time learning on the job, whether you call this a residency or OJT. I think the key is practice, practice, practice, not study, study, study.

Why are new RNs not hired to work in a limited capacity under supervision, doing work that would provide the exposure and opportunities to practice basic and essential skills? For example, performing the job duties of a practical nurse? I personally think a year of providing direct care would be invaluable. I'm sorry I spent all the time and money getting my BSN, because now I can't work in health care as anything less.

If the impetus to require BSN educated nurse is to improve patient outcomes, I believe there is more evidence for other factors, e.g., lower patient-to-nurse ratios; I'm sure years of clinical experience contribute as well. If the impetus is to increase respect for the profession, my observation is that there is a more pressing need to increase respect WITHIN the profession.

Christine, RN January 23, 2012 11:19 AM

I believe that nurses who hold an associates degree or diploma in nursing,coupled with at least 10 years of experience in the field should be grandfathered or awarded an honorary BSN.%0d%0a%0d%0aOne can not take away the knowledge that has been gained at the bedside by these very competent and knowledgeable nurses.%0d%0a%0d%0aIf they wish to implement such a law,do so from this point on and don't force unnecessary hardships on individuals who have already obtained the required education needed for licensure at this time.%0d%0a%0d%0aNothing can take the place of an ADN/ Diploma nurse with years of bedside experience.I certainly would choose a nurse with experience over one with a list of credentials after his/her name.

Paul Zajencki, Ambulatory Surgery - RN January 22, 2012 8:24 PM
Clifton NJ

I believe that nurses who hold an associates degree or diploma in nursing,coupled with at least 10 years of experience in the field should be grandfathered or awarded an honorary BSN.

One can not take away the knowledge that has been gained at the bedside by these very competent and knowledgeable nurses.

If they wish to implement such a law,do so from this point on and don't force unnecessary hardships on individuals who have already obtained the required education needed for licensure at this time.

Nothing can take the place of an ADN/ Diploma nurse with years of bedside experience.I certainly would choose a nurse with experience over one with a list of credentials after his/her name.

Paul, Ambulatory Surgery - RN January 22, 2012 8:22 PM
Clifton NJ

With more than 50 years of nursing experience in a variety of settings, including hospitals in Ohio, Calif, Wisc, & PA plus a private physicians' practice, in departments from NICU, med-surg, family health center to ED, and positions ranging from staff nurse, head nurse, supervisor, and patient educator - I believe my perspective to be relevant to this discussion.

Many of the comments citing the lack of experience & errors of BSN grads is well known by nurses & physicians working today.  Yes, most do eventually learn by experience BUT the mistakes could (& should) be avoided with better student education (including closer faculty supervision & especially much more patient experience) as mentioned in previous blogs.

BSN education does broaden one's knowledge but so does life & work experiences.  It does NOT replace the "nuts & bolts" education that diploma & some AD programs provide.  By the way, does anyone remember that the initial plan for AD programs was to include a 3rd year as sort of an internship program for the new grad to gain SUPERVISED work/experience before being fully done.  Due to the nursing shortage & costs to employers, this soon was lost!

This is an important discussion to have, but BSN as entry level requirement is flawed in todays education & working environments.

BSN programs need to be revamped to provide the skilled nursing care component so needed in todays world.  The aging population is creating an ever-enlarging patient group that nursing must be ready to meet.

My own BSN was obtained early in my career after an exceptional 3 year diploma program that based the 1st year at a local college for all classes, with weekends at the hospital for early introduction to real patients.  Yes, it went all year round which essentially made it close to a 4 year program.  All the college credits were transferable to a BSN program as they were "on campus" classes & many of the nursing credits also with a passage of a state exam to evaluate one's knowledge.  Thus the BSN program at Ohio State Univ only took 5 additional quarters.  Many similar ideas today could be accomplished - as well as the many on-line courses now available.  Costs need to be addressed or scholarships provided.  Some employers are subsidizing individuals too - this needs much more emphasis by nursing leaders.

At my 50th nursing reunion this fall, 15 of the 28 classmates were present.  11 had advanced degrees - 4 of us are STILL working! (I am working part-time because I still love it & know I have alot to offer to patients.) We are a very competent, accomplished group with a wide variety of work experiences AND NONE OF US WERE REQUIRED TO HAVE A BSN TO WORK - we desired ourselves!!

I hope more nurses add their thoughts as this is absolutely vital to help shape the nursing profession as health care as we once knew it is changing more & more.

Kathy Vollmer, Internal Medicine - RN, BSN, Physician Office January 21, 2012 2:50 PM
Camp Hill PA

I am heartened to read all of the above  comments regarding the necessity of a BSN degree.  I agree with all of the reasons stated. I too am an "older"  diploma educated RN and specifically chose that type of program for the clinical experience.  I love learning and expanding my knowledge but the cost of continuing my education would be very burdensome. I already have two parent PlUS loans for my children's education (one for a nursing degree).  Additionally the many of the programs I have researched don't excite me nor do they seem to offer anything that would better my skills at the bedside.

Until the RN to BSN programs are revamped to improve our ability to serve our patients you are going to continue to have this debate.

Cheryl Lachman, RN LNC January 21, 2012 12:45 AM

Firstly, my hats off to all nurses out there for the many contributions we make to society.  I just graduated with my BSN after working 11 years with my ADN.  Even though, it was one of my personal goals, I am glad I did because most healthcare facilities encouraging existing employees to obtain the BSN and the job market's preferred requirement is a BSN.  However, from my experiences the most dedicated and committed nurses have been the diploma and Associate nurses.

Marcia, Med-surg - Clinical leader, Lifebridgehealth January 20, 2012 1:18 PM
Owings Mills MD

Let me begin by saying I enjoy reading Advance for Nurses.

I am a pediatic RN with 12 years experience and I am a diploma nurse. I also have 12 years experince a a LPN. When I was a LPN I knew I had to obtain my diploma degree in nuring to better my nursing and futher my career. I thought I was doing the right thing, but now I find myself worrying if I will have a job in less then a year. My employer wants only BSN nursing and I had to sign a contract that I would obtain my degree in a little over two years. Let me ask you who wouldn't if they needed a job. I love where I work and the people I work with I love caring for children and there families. It is very sad that all I hear in NURSING is about getting a BSN, I thought we all became a nurse to care for the patient I don't need extra intials after my name to be a GOOD NURSE!!!!!!

Laura , Pediatrics - RN January 20, 2012 8:15 AM

I have been a registered nurse working in the ICU for 25 years. I attended a 3 year diploma program and always vowed if I went back to school it would not be for nursing.

My collegues and I discuss the pros and cons of going back to school. The cons outweigh the pros.  I agree with with many of the sentiments in previous posts.

 I do not want to fork out thousands, even with tuition reimbursement to make an additional five dollars per week. Working forty to forty eight hours per week to put my children through school, I do not want to torture myself with taking classes to provide college professors with an income.

I work with many "professional" BSNs who lack basic bedside care skills, who lack basic critical thinking skills and are basically not very good nurses. I love being at the bedside!

Do the BSN's get that little extra "professional respect" from doctors because they are more educated and well rounded? You tell me? No physician has ever asked me about my credentials. We will never be on par with MDs because we have extra letters after our name. They don't care. I get the respect I feel I earn.  Working as a team  as the bedside RN, I am an important member and make myself heard advocating for my patients.

I think a big issue is that many of you who have gone on for advanced degrees spent very little time at the bedside honing the unique skills and intuition one receives by being there in the trenches.  You got out asap and all the best to you for your endeavors but PLEASE, stop trying to force me to get my BSN. I would consider it if it were tuition free.  I don't want to hear it any more and I think many of us should start to protest against the "BSN in Ten" campaign.

Gerri Houde, ICU - RN January 19, 2012 10:41 PM
Marlborough MA

Wake up nurses the required BSN is so all those professors who teach the BSN programs can keep their jobs at your expense. Give me a diploma RN with 10 years experience any day over a BSN nurse with a clip board, lab coat and high heels.

Thomas Hendrickson, Trauma Manager January 19, 2012 9:26 PM

When this writer graduated from an ADN program in 1994, there were no hospital jobs in CT.  This writer worked in longterm care facilities, home care, as a nurse care coordinator, and in a psychiatric residential for adolescents.

BSN programs need to be tailored to meet an RN's educational needs.  Also, evidenced based practice needs to continue, but does every RN have to be forced to conduct research, especially when he or she might be nearing the end of a nursing career?

This writer might consider obtaining a BSN if advanced classes on medical topic was part of the curriculm.  Also, clinical hours in a hospital ED or Critical Care unit would be beneficial.  Due to lack of hospital nursing positions offered in the 1990s, this writer missed receiving vital medical surgical educations / experiences.

A manadatory class on effective communication and how support RN colleagues needs to be offered at the BSN level.  Nurses provide high quality patient care with compassion but can be extremely tough and unsupportive of one another.  Why would a nurse want to attend a BSN program that is taught by nurses with advanced degrees who display a condensending attitude towards nurses with LPN / ADN?

Tina, Pediatrics - RN, DCF January 19, 2012 7:50 PM
East Windsor CT

It is not a good idea to require a BSN as a requirement for continued practice in the field of nursing.  Many nurses with an  Associate Degree (ADN), also possess Bachelor's Degrees in other fields of study.  Education for a nurse never ends with a degree from a university.  Opportunities exist for CEUs, attendance at seminars, and ongoing work site education.  

An ADN nurse that possesses over 20 years of experience should not be forced to obtain a BSN and need to pay for the advancement of nursing education, with no financial assistance, especially if that RN has a Bachelor's Degree in another field.

Tina , Pediatrics - RN, DCF January 19, 2012 7:09 PM
East Windsor CT

It is unbelievable that the U.S. nurses fail to recognize the professional benefits of extending nursing education. In 1975 I was in a three year Hospital nursing program when the Canadian Nurses Association (CNA) announced their position statement for extending nursing education to require a BSN by the year 2000 as the entry level of RN preparation. The Hospital programs were the first to combine with universities and the Community College sought partnership with universities schools of nursing and accreditation for their courses. The CNA encouraged universities to accept Diploma nurses and provide RN ladder education. We realized we were in the educational tsunami together with aim to provide a nursing work-force with the skills required to provide safer health care, gain greater respect with practice autonomy. However, Donna Kelly-Williams, President of the Massachusetts Nurses Association has written an article in Vol.82 No. 6 of the MNA News Letter that the Massachusetts nurses explaining that the Massachusetts nurses want nothing to change with RN nursing requirements. Wrong. I am a MA registered one nurse who had an RN with a two year education insist that intravenous tubing coming out of a packaged box was ‘programmed’ according to the doctor’s order. Wrong. It is time nursing errors declined, medication errors declined, infections declined and patients became much, much safer during their hospitalizations. This can only be accomplished with a well-educated nursing work force.

Rosemarie, LTC & acute care - Health Care Faciity Inspector, DPH January 19, 2012 5:45 PM
Cambridge MA

It's time for the academic institutions to clean up their act.  We are all aware that professors want to retain their jobs and keep the tuition flowing, however, safety is at an all-time low in this country. A nursing student must be strictly monitored while she is performing clinical duties by all faculty, at all times, during her education, and that is not being done.  A procedure must be done proficiently three times before a student is signed off on it.  The BSN program is not graduating nursing students with proficient skills.  That is so obvious. The injection skills are the worst we have ever seen. The students are making far too many clinical & medication errors while they pour and prepare medications.  They also run off a shift and NEVER give the meds they do pour, making it difficult for the Staff Nurse to have to check their work and repour the meds correctly, without correcting the student.  That's a violation in itself.  If you pour it, you give it...not someone else.  The students today do not have good math skills.  It's time for more analytical math skills. Today's nurse also is not respectful or cordial to patients and visitors.  Time to stop calling patients by their first names.  When did Mr. and Mrs. go out the window? Somewhere the professionalism went out the window about 20 years ago. The long hair is not tied back. The fingernails are long. The cell phones are in use.  The distractions are now on overload. They ignore the patients. Year ago, Diploma nursing schools mandated that a student nurse take care of at least 20-40 patients on a unit, before graduation, even on the NIGHT shift.  Let's see that being done today before graduation! The Diploma schools can incorporate college courses into their cuuriculum.  It can be done. However, a lot more hospital clinical hours must be incorporated into a student's education and responsibility before she sets foot on a floor after graduation. Compare a diploma nurse vs. a college nurse with their skills, and you'll see the difference.  Even physicians can tell the difference. After being hospitalized over 15 times, I can report this honestly.  This is a very serious issue.  Before the BSN mandate becomes law, a whole lot of clean-up in the profession must be done.  Advanced education is great, however, the core nurse must be educated correctly from the start.   Older nurses must be grandfathered into the system for their years of experience, knowledge and on the job training & CEUs.  A "Grandfather Clause" should be mandatory to save and preserve the older nurses' postions.  We definitely need that!

Sue Scherman, Medical Research - RN, Law Office January 19, 2012 2:03 PM

At first, I was resistant to the idea of the "BSN in Ten", thinking about what a hardship it might be for my AD students/grads.  But I have come to realize that in order for nurses to play an equal role in health care, we must be as educated as other health professions.  Further education can - and does - make a difference to our profession and to our patients.  I am in support of requiring RNs to hold at least a BSN.

Fran Hilliard, Nursing - Prof Emerita, Nassau CC January 19, 2012 11:03 AM
Garden City NY

Amen to MD in PA.  I gave the long version.  You were short, sweet and right to the point.  It is about the money.  Look at who Linda Aiken Works for.

Glad to see there are still some people out there with common sense who can think for themselves and don't just buy into the latest propaganda because it's the trendy thing to do.  

Peter DiGiuseppe January 18, 2012 9:19 PM

I cannot believe the propoganda surrounding this issue based on one very questionable study. Legislation supporting this travesty is in support of only one thing:  money.

Put an advanced-degreed nurse manager on a floor with a slot of 10 patients and you will really see patient mortality rates increase!

MD January 18, 2012 6:59 PM

As a Diploma nursing school graduate from 1971, I am also proud of my professional education and 38 years of continuous nursing experience. I have continually upgraded myself on continuing education, reading all journals, and conducting constant medical and chemical research. I still care for many individuals on an emergency basis.  I am also a nursing author of two nursing textbooks, and I hold a U.S. Patent and Trademark on a medical device.  I hold a Bachelor of Arts degree in Health Science and I am a Certified NJ School Nurse and Health Education Teacher.  I always take advantage of furthering my education for whatever job I hold. Unfortunately, the loans are exceptionally high (which made me drop out of Dental School) and I do not choose to compromise my home life by paying back exorbitant fees to colleges.  I also like to see my family once in a while. My hours at work are exceptionally high and I am exhausted like most Americans when they get home at night. I have no interest whatsoever in a BSN degree.  From the BSN students whom I have supervised, I see many mistakes, a lack of procedural experience (such as injection administration), numerous medication errors, etc.  There is nothing that makes me want to obtain a BSN degree.  At least the BA taught me how to write goals and teach a curriculum.  This degree is scoffed at by my peers, but it is a vital degree in School Nursing.  I was also a School Nurse for 3 years.  Why is a BSN going to make me a better nurse.  I get many compliments on my nursing school experience with the three years of extensive hands-on supervision.  BSN students DO NOT get that and they are making far too many errors since the instructors cannot be with them all the time like in a nursing school setting.  This is a public safety issue.  The patients deserve excellent hands-on care.  I say bring back more nursing schools.  It will improve hospital care and make better nurses.  I have been in risk management and law for over 20 years. Time to stop making multiple mistakes.  Most of the hospital mistakes are not being reported and these students (and later RNs) are continuously making serious patient errors.  Continuing Education will always be mandated. That's enough to keep us apprised on newer procedures, medicines, education, etc.  I do not support any BSN degree when we have enough now to keep apprised of in the job market.  There is way too much continuing education to constantly read.  I don't want the debt and my employers are not willing to supsidize my schooling. Grants and scholarships in this country are impossible to obtain. I have tried.  When they make the education free in this country, I might consider going back to school. For now, I have to keep a roof over my head and feed my family.  There’s no extra money for tuition. No need for a BSN.

Susan, Law - RN Paralegal, Law Firm January 18, 2012 10:19 AM

Dear Advance Magazine:

I want to preface this by saying I enjoy reading your publication.  It is thought provoking and informative.  However, I've been noticing that in almost every issue there is at least one  article  that tries to plant the seed in the minds of nurses, employers and the public that nurses who go back to further their education at a college or university will turn out to be better nurses.

I think it's great if a nurse chooses to go back to school to further their education.  What I am against is requiring nurses to go back to a formal school to increase their knowledge.  I have also found that most of those in favor of such a requirement are somehow affiliated with academia.  Ms. Bensing, with all due respect,  admits that most of her career was spent in academic and continuing education. If current laws where changed to require nurses to formally obtain a BSN or a higher degree will undoubtedly mean vast amounts of revenue for colleges and universities.  To believe that schools are not looking at the financial gain from such a requirement, one would have to be living in a fantasy world.

To assume that learning can only take take place through a college or university is both ignorant and short-sighted.  If the goal is purely to have nurses further their knowledge, why shouldn't nurses be able to earn a BSN by reading articles and publications and then take a short test or write a short essay response to show that they've absorbed the material.  This may work especially well for nurses who graduated from an Associates or Diploma program and have previously earned Bachelor's Degrees in other areas.  Nurses could further their knowledge this way but schools would not enjoy the millions of dollars of revenue that would result from requiring nurses to attend a college or university.

Critical thinking skills and the ability to respond in emergency situations are developed and honed through experience and through working with those who have many years of experience and enjoy imparting knowledge and not by going back to a college or university. Requiring nurses with over 20 years of experience and specialty certifications that demonstrate mastery in those specialties would make no sense and may cause many of our most capable and experienced nurses to leave nursing which will could be a drain on the profession and a danger to the general public.  These are the nurses that you and I would want to have taking care of us.  Many of these nurses are in their late 40s or early 50s and to spend thousands of dollars to earn a higher degree when they will be retiring before it is paid off is illogical.  Once more, the nursing managers and supervisors I've spoken to have seen no increase in the level of care provided by a BSN as opposed that provided by an RN.  They all told me that experience made the difference in the level of care provided, not the amount of post-RN education.

One of the things I would also like to ask is that those who have a nursing license coupled with a Bachelor's degree in another area be given the same consideration as those with BSNs.

You magazine has thus far presented the one-sided argument in favor of those who want to require nurses to earn higher degrees.  I would only like to ask for equal consideration to present another point of view.


Peter L. DiGiuseppe, B.A., RN

P.S.  I have also contacted the PA State Nurses Association and am also preparing a letter to be sent to our governor concerning these issues.

Peter DiGiuseppe January 18, 2012 2:53 AM
Philadelphia PA

I am a 1966 RN diploma graduate who is proud of my nursing program. As students we spent our freshman year at a local university taking the same courses all freshman took. We then came back to our nursing school and spent another 3-4 hours in nursing classes. The program was year round with no summer breaks. My junior year was spent in daily clinicals and nursing classes. My senior year was spent learning charge responsibilities on the hospital units and taking nursing classes.

The first day at my first job I was nervous but I new that I had the education and clinical experience to transition into my nursing practice with ease. This is not the case for many nursing graduates today who complain of gaps in their education and training. .  I am forever grateful for having chosen my diploma program. I have in later years obtained my BSN and MSN and now am near completion of my PhD but I feel that my best basic nursing experience came from my RN diploma education.

I do not feel the education of nurses today is properly set-up to train nurses. I feel the BSN programs do not prepare students for the real world environment of nursing. I do not agree with the ANA in designating the BSN as the standard minimum degree for RN entry into nursing practice. Many BSN programs are missing the critical experiences needed to provide competent nurses in practice. Many BSN programs are relying heavily on simulation programs to provide clinical experience for student nurses. There is a critical shortage of experienced clinical instructors and so students are told by their instructor that has 20 students to divide over several nursing units to go and learn and observe. Many great changes to apply their new nursing skills go by because this instructor is too busy with another student to help this student. Assistance from staff to be preceptors is also limited because the staff nurse has a heavy patient load and no time to help.

We need to revamp our nursing education. If we still want to have BSN be the standard we should have the first three years academic  and the forth year a full year of clinical experiences bot on the nursing care unit and in the community. This can be set-up like an internship as they learn to be part of a nursing team.

As a practicing nurse and educator for 46 years, I have seen our education of nurses falter due to economic factors, nursing shortages, lack of adequate nursing faculty, and the poor cooperation and collaboration between nursing programs and healthcare institutions over the amount of time and space allowed for students to practice in real life environments. Why have we allowed this to degrade our profession. We still are considered the most trustworthy of professions so why are we letting the public down?

It is time our nursing profession and organizations worked together to develop a standard curriculum that all levels of nursing could contribute toward. Is it not our goal to provide the best education for our nursing students so they will be able to enter the workforce knowing they are competent with knowledge and skills necessary to safely enter the practice of nursing?  

Diane Glasser, Nursing - Faculty January 17, 2012 4:02 PM
Lebanon PA

I am against the requirement that all entry level RNs have a BSN degree.  I enterered the nursing field as a second career at the age of 48.  I had previously worked in another field for over 20 yrs having attained a bachelors degree in business admin prior to that. It wou

D be quite a hardship for me both personally and financially to continue my education at this time to attain a second bachelors degree. I do not believe that having that degree would add to my high level of professionalism and compassion I now bring to nursing.

William, Neuro - RN, Helen Hayes Hosp January 17, 2012 2:43 PM
W Haverstraw NY

Obtaining a BSN is a great achievement, however many students are now facing difficulty getting a job without having experience... its a catch 22... nothing wrong wiith furthering your education but it would be nice to know that doing so would ensure you will find work.

Meli January 17, 2012 12:13 PM
New York NY

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