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Hollis Forster, RN

Twenty five years ago, nursing instructors told their students that in just a few years there would be no Associate degrees in nursing. All nurses who hoped to work as registered nurses would need to be Bachelor’s or Master’s trained.

Today, according to Nancy Tucker, Dean at Pacific Union College in Angwin, California, two thirds of nursing graduates every year complete their training with an AS (Associate of Science) or ADN (Associate Degree in Nursing) degrees. The Associate degree trained nurse persists, providing hospitals and out patient centers with proficiently trained nurses to manage their patient care. According to Ms. Tucker, there just are not enough graduates coming out of the BSN (Bachelor’s of Science in Nursing) programs to fill the needs of nursing across the state or the nation. Two year programs are here to stay, at least for the foreseeable future. The popularity of these programs is evidenced by the wait to enter these programs. In many schools across California, it can take two or three years to get to the top of the list to enter the nursing courses after completing general requirements. These programs are not only active, but thriving.

What about pay or advancement differentials? AS trained and BSN trained nurses are often treated equally in the hospital and out-patient setting. There are no substantial pay differentials, and nurses holding either degree have the same opportunities to become a charge nurse or director of a department.

So, what is the difference and how will it affect the course of a career in nursing? In today’s nursing world, more is expected from a nurse than following doctor’s orders and starting IVs. The nurse must be able to make critical decisions about a patient’s care, to question the doctor if orders seem inappropriate and to help the patient through, sometimes, difficult life-changing decisions. These skills take an education that is broad based, one that includes critical thinking and exposure to many different people, thought processes, and culture and societal norms. Two year nursing programs do recognize these needs and address them as they can, requiring liberal arts classes to be taken before entering the program and teaching decision making skills along the way. At every level of nursing, the ability to connect with different people, recognize the pressures they face from their personal environment and find value in each is critical. This is a lot to learn against a backdrop of proficiently performed procedures and giving the right medication.

What Can a BSN Get You?

BSN programs offer more education aimed at developing these skills. These programs bolster knowledge about community and public health issues. There is also more attention paid to nursing management, that is, enhancing skills needed to help “direct reports” do their best work for the patient and the health care organization. Opportunity to refine patient assessment skills and examine more in depth the patho-physiology of diseases, also sets these programs apart from their two-year sisters.

Nurses who graduate with a BSN degree will find it easier to enter faculty teaching positions, higher level administrative roles in hospitals or other health care environments and State or Federal level government nursing jobs. And for some, these roles are more satisfying, allowing the individual to affect change at a more global level than one-on-one nursing.

While it is true an experienced, talented nurse with an AS degree can move “up the ladder” into management and leadership roles, the Bachelor’s degree can make the climb a little less steep. And, with all this said, there will always be a critical role for the nurse who works directly with the patient, teaching patients about their health care, assuring quality wound management in the hospital setting and observing patients for signs of a worsening condition.

Nursing is a huge and welcoming field. It offers a satisfying career path for both AS and BSN trained nurses. Whatever path you have chosen in nursing, the essential wisdom is to continue enhancing your skills and education so that your community, your organization and your patients benefit from your broadened view of the world.

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