Whether you have a diploma, an associate’s degree in nursing (ADN) or a bachelor’s degree in nursing (BSN), landing a nursing job these days usually isn’t a problem. Advancing in the profession, though, is another matter if you hold less than a BSN, according to experts.
But is the BSN always a necessity? Is an associate’s degree alone enough to open the door to a rewarding nursing career?
The bottom line is that choosing a nursing degree depends on the individual’s needs and goals, says Donita Qualey, RN, MN, president of the National Organization for Associate Degree Nursing and professor of nursing at Delgado Community College in New Orleans.
“If the career goals are always to work at the bedside, then the associate’s degree is perfectly fine,” Qualey says. “But if you’re younger and want to teach or go higher in management, then you would go on for your advanced degree.”
Lower Nursing Degrees Under Scrutiny
Even though nurses' most common initial preparation is an associate’s degree, nursing organizations are pushing for nurses to earn higher degrees.
The American Association of Colleges of Nursing (AACN) says having nurses prepared at the BSN level translates into better patient care. An AACN fact sheet cites studies and data showing lower mortality rates, fewer medication errors and more positive outcomes when nurses are prepared at the baccalaureate and graduate levels than at the associate’s and diploma levels.
State boards of nursing are behind the drive to eliminate lesser degrees in nursing as well. A proposal by the New York State Board of Nursing requiring all ADN nurses to get their BSNs within 10 years died in the legislature. But other states, such as New Jersey, are considering similar proposals, Qualey says.
Considerations for Second-Career Nurses
However, many who go into nursing as a second career don’t have the time or money to earn a four-year degree and are content staying at the bedside, says Sally Durand, RN, MSN, director of the associate-degree nursing program at Alvin Community College in Alvin, Texas.
Second-career nurse Laura Soria, RN, ADN, earned her associate’s degree in her early 40s. A nurse for the Brazoria County Health Department in Angleton, Texas, Soria says she is perfectly happy with her level of education and the job opportunities available to her. However, pressure from coworkers, including doctors and fellow nurses, makes her feel inadequate.
“I think a lot of people look down on the ones who just have the [ADN],” Soria says. “At my age...I love my job and changing my [credentials at the end of my name] would not help me in the job that I’m in. Basically, the only thing the BSN will get you is a managerial job. I don’t want to be the boss. I think it really matters what your goals are.”
Degree as a Stepping-Stone
For others, though, the associate’s degree is a first step on the road to advancing in nursing.
Stacy Vicknair, RN, ADN, a public health nurse for the Brazoria County Health Department, has no plans to return for her BSN but might take classes to further her career.
“These would be credentials that will go with my ADN,” she says. “I anticipate taking a forensics nursing class and classes that will further my career within the county.”
Regina Porter, RN, BSN, MSN, a nurse clinician III on the cardiac telemetry unit at The Johns Hopkins Hospital in Baltimore, is glad she went back to school after getting her ADN.
“By going back to school, you definitely get more insight, more experience in your clinical practice, more critical-thinking skills,” she says. “I think you have a different perspective on things.”
Patricia Miller, BSN, a staff nurse on the medicine/telemetry unit at The Johns Hopkins Hospital, says getting her BSN after the ADN helped her hone her leadership skills to take on bigger roles.
“Now I’m considering going to graduate school,” Miller says.
Advancement, Earning Power
Academic institutions such as Hopkins hire nurses prepared at the associate’s level, but reward nurses throughout their careers for completing more education.
At Hopkins, both two-year and four-year graduates new to the profession would start in the same job, doing the same kind of work, says Karen Haller, PhD, RN, the hospital’s vice president for nursing and patient-care services. However, to advance to the fourth and fifth of five nursing levels before going into management, Hopkins nurses must have a BSN, she says.
“For every jump on that ladder, there are increases in title and compensation,” she says. “So the baccalaureate has a brighter future in terms of earning power.”