Nursing: Is the BSN Worth It?

By Deborah Jeanne Sergeant

Beginning in 2020, new registered nurses will be required to earn their bachelor’s in nursing (BSN) within 10 years of their initial licensure. Existing RNs will be grandfathered in.

But is earning the BSN worth it?

Yes, according to Cheryl Nosek, doctor of nursing science, professor and chairwoman of the nursing department at Daemen College in Amherst. More baccalaureate-trained nurses promotes better care, she said.

Nosek cited a 2003 research by nurse Linda Aiken, PhD, at the University of Pennsylvania, which states that increasing the number of baccalaureate-trained nurses improves patient outcomes.

“It’s definitely a step in the right direction for health care,” Nosek said. “The research shows that hospitals with 10 percent more of baccalaureate-trained nurses than associate-trained nurses have a 7 percent decrease of patient death. She’s done several studies herself and found similar results. We have pretty convincing evidence it makes a difference.”

In addition to improved patient outcomes, Nosek also thinks it will help nurses. Many health care organizations want bachelor-trained nurses, especially for positions in management and leadership.

“There are definitely more opportunities for baccalaureate-prepared nurses,” Nosek said. “Hospitals are looking for bachelor’s prepared nurses. If you don’t get it, the positions are more like in skilled nursing facilities. If you really want to work in a hospital, to secure that position, the BSN will be a tremendous help.”

She added that even lateral moves within a hospital, or re-hire by the same organization, often require a bachelor’s degree.

Nearly all positions for nurses involving research, technology or education require the BSN. Without the additional education, these higher-paying positions are usually out of reach.

Physician extenders — physician assistants and nurse practitioners — are in greater demand to help fill in the gaps because of the physician shortage. Baccalaureate-trained nurses can further help extend the care because of their additional training.

RNs often serve on multi-disciplinary teams where many of the other members have received at least bachelor’s level training, such as occupational and physical therapists.

“That doesn’t mean RNs are not good nurses,” Nosek said. “The BSN add something to the nurse’s critical thinking and clinical skills. It’s not that RNs don’t provide good care.”

Most schools’ RN-to-BSN program takes one year full-time or two years part-time. Because many RNs are still working when they want to earn their BSN, many schools work with students to offer online classes that they can work on at any time.

Many health care institutions work with RNs through tuition reimbursement programs because they want to employ more BSNs.

Any hospital with “magnet status” actively seeks baccalaureate-trained nurses. The American Nurses Credentialing Center began its magnet recognition program in 1993. The hospitals with magnet status demonstrate more satisfaction among their RNs, low nurse turnover and improve patient outcomes.

Nosek said that magnet status empowers nurses at the bedside and gives them more control over how they practice.

By employing more baccalaureate-trained nurses, hospitals can better achieve their goals. The organizations are also required to hire more BSN employees, especially for nursing leadership roles.

Michele McKay, certified nurse educator and president of the Professional Nurses Association of Western New York, said that further training helps nurses keep pace with the dramatic changes in healthcare that has taken place in the past 20 years. She holds a master’s degree in nursing.

“We’ve seen a lot of changes in technology and the systems that care for patients,” McKay said. “With all the changes, the complexity of health care has increased dramatically. There are much fewer in-patient beds than there were even 10 years ago. Today’s RN has to be able to make a lot of independent, critical decisions, sometimes in very independent settings.”

Health care systems and insurance have also become much more complex. McKay said that baccalaureate training can help nurses better navigate these issues.

“We by all means support all levels of RN, but our mission is to educate and promote professionalism in nursing for the benefit of our community,” McKay said. “It’s not like an associate’s degree nurse isn’t a skilled, educated practitioner who provides good care.”

Whether a BSN or RN, nurses sit for the same board examinations.

“The bachelor’s degree that promotes greater engagement in how to make effective change for our patients and communities,” McKay said.