ADN vs BSN Debate

With the number of different ways to get into nursing, there are often many different opinions and debates on which degree path you should choose. We cover the key differences, the pro’s, and the con’s of getting your ADN (Associate’s Degree in Nursing) and BSN (Bachelor’s Degree in Nursing) degree.

Difference Between ADN and BSN Degree Programs

According to the United States Bureau of Labor Statistics, the demand for Registered Nurses should grow by approximately 26 percent through the year 2020. This is promising news for those who are considering entering the nursing field. Prospective nurses have two main pathways into this rapidly expanding profession: an Associate Degree Nursing (ADN) program and a Bachelor of Science in Nursing (BSN) program.

Both of these programs prepare students to take the National Council Licensing Exam for Registered Nurses (NCLEX-RN), but prospective students should consider the differences between the programs and carefully weigh the pros and cons of each before making a decision.

★ Featured Online Nursing Programs

The following schools have online entry level nursing or healthcare programs and are currently accepting applicants from around the US. Get in contact with them for more information on their programs and admissions standards.
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Length of Program

If a student attends school on a full-time basis, he needs four years to complete a BSN degree. Most schools require the nursing student to earn at least 120 credits in order to graduate. Roughly half of these credits are devoted to liberal arts classes and science prerequisites. As an example of a typical BSN program, nursing students at Pittsburg State University need to earn 125 credits. Of these, sixty-six are for the university’s general education requirements and for the nursing department’s prerequisites. These classes take two full years to complete. Nursing students begin nursing classes and clinical rotations in their junior year. This is a typical course progression for BSN programs, although some programs are structured differently.

ADN programs, on the other hand, take 2 to 3 years to complete. While Associates Degree in Nursing students do need to take science prerequisites and some liberal arts classes, they don’t have to earn nearly as many credits in this area as BSN students do. For example, to complete an associate degree from Harry S. Truman College (part of the City Colleges of Chicago), a student must earn sixty-nine credits total. As opposed to the BSN student who must complete more than sixty general education credits, he must earn twenty-eight credits for general education classes and science prerequisites. Instead of the sixty-six nursing credits that a BSN student must complete, the student in the associate degree program needs forty-nine nursing credits. The program at Harry S. Truman College requires one semester of prerequisite classes and four semesters of nursing classes; although each Associate Degree Nursing program is slightly different, this course progression is typical.

Program Prerequisites

While most ADN programs take two years (four semesters) to complete, this typically does not include the time required for prerequisites. Each ADN program has its own prerequisites, but the following are typical: human anatomy, physiology, microbiology, English 101, developmental psychology, college algebra. An Associates Degree Nursing student should plan on spending one to two semesters completing prerequisites, extending the time required to complete the program from two to two-and-a-half or three years. BSN programs usually have prerequisites as well, but these are always included in the four years. Most nursing departments at four-year colleges require prospective nurses to apply to the college, and spend two to four semesters completing prerequisites before applying to the BSN program. Before beginning a BSN program, students generally have to complete a good portion of their required general education courses as well as the following science classes: human anatomy, physiology, microbiology, general chemistry. Many programs also require nutrition, statistics, developmental psychology, general psychology, sociology.

ADN vs. BSN Competencies

Nursing programs are accredited by the National League for Nursing Accrediting Commission (NLNAC) or the Commission on Collegiate Nursing Education (CCNE), as well as approved by the state board of nursing in the state where the program is located. In order to be accredited and approved, the curriculum must meet certain standards.

Any program, whether it is an ADN program or a BSN program, must train students to perform nursing tasks in all the main areas: maternal-child nursing, surgical nursing, adult nursing, mental health nursing. Both ADN and BSN students learn the same nursing skills and, on a technical level, are equally prepared for the NCLEX-RN and entry into the nursing field. However, in additional to technical competence,  BSN programs generally have a strong emphasis on critical thinking skills, decision making and problem solving, leadership, and nursing theory.

For example, Idaho State University lists the following competencies for its BSN graduates: critical thinking, leadership, technological competence, effective communication, population-based health, professional behavior, and clinical practice. By way of comparison, another college in the same state, North Idaho College, lists the following competencies for its ADN graduates: professional and ethical behavior, effective collaboration with others in providing healthcare, apply nursing knowledge, and practice in a safe and caring manner. As this example shows, ADN programs do not have the same emphasis on leadership, nursing theory, and critical thinking.

The American Associate of Colleges of Nursing (AACN) confirms this fact, stating in its media release called “ The Impact of Education on Nursing Practice, ”Baccalaureate nursing programs encompass all of the course work taught in associate degree and diploma programs plus a more in-depth treatment of the physical and social sciences, nursing research, public and community health, nursing management, and the humanities. The additional course work enhances the student’s professional development, prepares the new nurse for a broader scope of practice, and provides the nurse with a better understanding of the cultural, political, economic, and social issues that affect patients and influence health care delivery.”

Cost of Program

Finances, of course, play a large role in choosing between an ADN and a BSN program. ADN programs, which are usually found at community colleges, are significantly cheaper than BSN programs. For example, Cuyahoga Community College in Ohio states that its ADN program costs just over $5000 for in-county residents, and about $14,000 for students who are not from the county or the state. In comparison, completing a four-year BSN degree from the University of Rhode Island costs about $48,000 (not including room and board). Since the University of Rhode Island is a state school, tuition is cheaper than at a private university. Earning a BSN degree from a private, four-year college can cost well over $100,000. For example, St. Mary’s College in Indiana charges about $33,000 each year in tuition, bringing the cost of a BSN degree to $132,000 (not including room and board). Of course, tuition costs can vary from state to state and from school to school, and students can also help reduce costs through scholarships and grants, but in general students can expect to spend significantly more money on a BSN degree than on an ADN degree.

ADN vs. BSN Salary

Both ADN and BSN graduates take the NCLEX-RN and earn the title of RN (Registered Nurse). They can apply for the same entry-level positions at doctors’ offices, hospitals, and other healthcare facilities. Although some hospitals may have different policies, in general ADN and BSN graduates will earn the same amount for an entry-level job as an RN. (The Bureau of Labor Statistics states that the average yearly earnings for an RN is close to $65,000.) However, nurses should take several factors into consideration. First of all, in choosing between applicants, employers are likely to prefer a nurse with a BSN. BSN-prepared nurses, then, have a better chance of getting a competitive position. Secondly, most employers look for a BSN-prepared nurse for management positions. Although an ADN graduate may have no trouble finding a position as an RN, she may have trouble advancing from an entry-level position to a supervisor position. As a result of these factors, BSN-prepared nurses may end up earning more over the course of their careers than ADN-prepared nurses.

Graduate Education

A nurse can advance in his chosen profession by completing a Master of Science in Nursing (MSN) degree or a Doctor of Nursing Practice (DNP) degree and earning advanced practice certification as a Nurse Practitioner (NP), Clinical Nurse Specialist (CNS), certified registered Nurse Anesthetist (CRNA), or Certified Nurse Midwife (CNM). A BSN degree, however, is a necessary prerequisite for nearly all MSN and DNP programs. A prospective nurse should take this into consideration before choosing between an ADN or BSN program. If he wants to eventually pursue graduate education in the nursing field, he should seriously consider saving time over the long run by starting with a BSN program.

ADN to BSN Programs

If, at some point in his career, an ADN-prepared RN decides that she wants to complete an MSN or DNP degree, she has the option of completing an ADN to BSN program. After earning her BSN through one of these programs, she would be eligible for admission to any MSN or DNP program. A typical ADN to BSN (also called RN to BSN) program includes additional general education classes, advanced science classes, nursing theory classes, leadership classes. Many colleges try to accommodate working nurses by offering ADN to BSN classes online. Students complete the coursework at home, at their own pace. Clinicals can be arranged in a location that is convenient for them. Other colleges offer evening or weekend classes, many of which are in a hybrid (partly online, partly on site) format. Nurses in an ADN to BSN program generally have the option of studying either full-time or part-time. As a result of all these choices, an RN who wants to earn her BSN should have no difficulty in finding a program that can accommodate her unique situation and working schedule. As a further consideration, many hospitals and physicians’ offices will pay for their employees to complete an ADN to BSN degree.

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Future of Nursing Education: Research/Studies

Nurse-researchers and leading nursing organizations are calling for higher levels of education among nurses. To name just a few studies/recommendations, the Institute of Medicine in 2010 issued a report entitled “The Future of Nursing,” which called for an increase of 80 percent in BSN-prepared nurses by 2020. Also in 2010, the Tri-Council for Nursing (composed of the American Association of Colleges of Nursing, the American Nurses Association, American Association of Nurse Executives, and the National League for Nursing) published a statement entitled “Education Advancement of Registered Nurses,” which called for RNs to earn their BSN degrees. As the AACN says, “BSN nurses are prized for their skills in critical thinking, leadership, case management, and health promotion, and for their ability to practice across a variety of inpatient and outpatient settings.”

Legislation: BSN-in-10

As a result of these studies, as well as many others, there has been a call for legislation requiring newly licensed Registered Nurses to earn their Bachelors of Science in Nursing degrees within ten years of graduation. Proposals for this BSN-in-10 legislation have been introduced in New York and New Jersey, and other state nursing associations are considering the proposal as well.

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BSN as the New Standard for Registered Nurses

Considering these studies and legislation, it seems that the nursing field is moving gradually toward naming the BSN degree as the new standard for RNs. While currently practicing Registered Nurses (RNs) who do not have their BSN degree will not be required to return to school, future RNs may be required to complete an ADN to BSN program. As a further consideration, if a BSN degree does become the new standard in the nursing field, ADN-prepared nurses may find that they are not as respected in their chosen profession as their colleagues who have a BSN degree. This may impede their career advancement. In light of the trend toward higher education for RNs, if they have the time and money, prospective RNs should seriously consider just getting their BSN initially.

ADN versus BSN: Conclusion

Ultimately, when choosing between an ADN and a BSN program, every student needs to consider his own unique circumstances. A student who enjoys lots of patient interaction and is happy to be an RN for his entire career may not need to invest the time and money required to complete a BSN degree. In her circumstances, an ADN degree may be all he needs to begin a fulfilling, challenging career (unless, of course, future legislation eventually requires him to earn a full BSN degree). On the other hand, a student who sees himself overseeing other nurses, being a primary caregiver, or educating future nurses will need a BSN degree in order to achieve his goals. She or he should invest the time and money in a BSN degree. In their case, the BSN degree is truly an investment, since he can count on higher earnings as an advanced practice nurse later in his career.

★ Featured Online Nursing Programs

The following schools have online entry level nursing or healthcare programs and are currently accepting applicants from around the US. Get in contact with them for more information on their programs and admissions standards.
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