BSN in 10 Legislation

BSN-in-10 Legislation Overview
In New York and New Jersey, state legislatures are considering a new bill known as “BSN in10.” If passed, the bill would require a Registered Nurse (RN) who holds either an Associate Degree in Nursing (ADN) or a diploma in nursing to return to school and complete a Bachelor of Science in Nursing (BSN) degree.

This bill would only apply to future nurses; nurses who are already practicing and students who are already enrolled in an ADN or diploma nursing program would be exempt. Those who enroll in a nursing program after the bill is passed would be given 10 years after licensure to complete a BSN program. If the BSN-in-Ten bill passes in New York and/or New Jersey, its implementation will be closely observed by other state nursing associations, which may urge their own state legislatures to introduce similar legislation.

Reasons for the BSN in Ten Bill

The BSN-in-10 legislation has wide support from national nursing associations, based on years of research.  Multiple studies have linked better patient results with more educated nurses. One of the many studies, conducted in 2003 by Dr. Linda Aiken and published in the “Journal of the American Medical Association,” noted a 5 percent decrease in patient death when the number of BSN-prepared nurses in the hospital rose by 10 percent. The findings of this study were confirmed with further research by different scholars in 2005 (published in “Nursing Research”), in 2007 (published in the “Journal of Advanced Nursing”), in 2008 (published in the “Journal of Nursing Administration”), in 2008 (published in “Health Services Research”), and in 2011 (published in the “Journal of Nursing Scholarship”). A higher percentage of BSN-prepared nurses has also been linked to better hospital organization. Healthcare administrators and nurse-researchers also believe that BSN-prepared nurses have stronger communication, leadership, and critical-thinking skills. In light of all these studies, the leading nursing associations have voiced their strong support of the BSN-in-10 legislation. Included among these associations are the American Nurses Association (ANA) and the American Association of Colleges of Nursing (AACN).

Implementation of BSN in 10

If the BSN-in-10 bill passes in New York, New Jersey, or any other state, implementation will require cooperation between colleges, state nursing associations, and employers.

Articulation Agreements

State nursing associations and colleges in the state will need to put together articulation agreements that would allow a seamless transition from ADN programs into RN to BSN (also called ADN to BSN or RN completion) programs. An articulation agreement would ensure that all classes completed as part of an ADN program would transfer to a four-year college, allowing the RN to complete her BSN without repeating any coursework. Some states, including Florida, Connecticut, Arkansas, Texas, Iowa, Maryland, South Carolina, Idaho, Alabama, and Nevada, already have articulation agreements in place.

RN to BSN Programs

Colleges will need to expand capacity in their RN to BSN programs and new RN to BSN programs will need to be established in order to accommodate the demand. Currently, according to the AACN, there are 650 RN to BSN programs in the United States.


Hospitals, physicians’ offices, and other healthcare facilities will need to cooperate with their employees in order to comply with the BSN-in-10 bill. In particular, they will need to provide their employees with the flexibility they need to return to school. They may also need to provide tuition assistance to offset the significant cost of an RN to BSN program.

Effect of the BSN-in-Ten Requirement on Registered Nurses

The BSN-in-10 bill provides an exception for RNs who are already working in the field or are already enrolled in a program, but these RNs may be affected anyway. Although they will not be forced to return to school, they may find that, with a growing presence of BSN-educated nurses, it is harder for them to advance in their career.  When in competition with BSN graduates, they may have difficulty moving into supervisory positions or getting competitive jobs. As a result, they may have to complete an RN to BSN program anyway, although not required by law. Future Registered Nurses will have to comply with the bill’s 10-year limit on completing a BSN degree. This will require a significant investment of time, but fortunately most colleges try to accommodate working schedules by providing extremely flexible RN to BSN programs. Many RN to BSN programs are offered online; students can complete the coursework at their own pace from home, and may even be able to schedule clinical rotations in a location that is close to home. Other programs are available in a hybrid format, so that the student only has to travel to campus several times a semester. RN to BSN classes are available in the evenings and on the weekends. Students can study on a full-time basis or on a part-time basis. On a full-time basis, an RN should be able to finish an RN to BSN program in as little as a year and a half. On a part-time basis, a student can take as much time as he needs to finish the program. According to the Executive Director of the New York Organization of Nurse Executives, even if an RN only takes one class per semester, he should still be able to meet the BSN-in-10 deadline.

Future of RN Education

Even if the BSN-in-10 legislation does not pass in New York or New Jersey, it seems that the BSN degree will slowly become the new standard for RNs. There are several indicators that the field is moving that way, even if it isn’t mandated by law. For example, in order to earn and keep the “Magnet” title awarded by the American Nurses Credentialing Center, hospitals have to have a certain percentage of BSN-educated nurses. Many hospitals, as a result, strongly prefer to hire RN’s with their BSN, and some hospitals are even requiring their ADN-educated employees to enter RN to BSN programs.  Some countries, including Canada, Sweden, Portugal, Brazil, Iceland, Korea, Greece, and the Philippines, have passed laws requiring nurses to have a four-year degree. Whether the BSN-in-10 legislation passes or not, it seems that it is only a matter of time until the BSN degree is the new standard for RN’s.