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Career Beat

Two-Way Dialogue: Readers Split on BSN Entry-Level Debate (part II)

Happy New Year! With a fresh year ahead of you, perhaps now is a good time to conduct a personal and professional inventory - a recapping of your previous year's accomplishments and deficiencies followed by a strategic plan for the coming year. Perhaps education figures into your career plans for 2004.

With this in mind, let me add just a few more words about the advanced education issue I addressed in recent columns. Speci.fically, I advocated that the BSN should be the entry level of education for nursing. This was in response to the defensiveness expressed by some nurses after ADVANCE published an article on Linda Aiken's recent study correlating patient outcomes with education levels. In the study, patients in 168 Pennsylvania hospitals had lower mortality and failure-to-rescue rates when they were cared for by nurses with a BSN or higher degree.

Lifelong Learning
The letters continue to come in - some who agree with me that all nurses should support the BSN-entry level goal and work toward making it reality. Then there are others who have been insulted that I would equate a nurse not advancing her education with lack of commitment to the profession.

"Kay Bensing can question my commitment to my profession all she wants, but my focus is my family, not more school," asserted one nurse. That's great that her priority is her family. However, in a dynamic profession like nursing, lifelong learning is essential if nurses are going to stay current with the many changes in healthcare today. To be fair, this nurse doesn't indicate if "no more school" includes continuing education.

Another nurse, a diploma grad, agrees that nursing has too many levels of education. She took me to task in noting that I never clearly stated that the BSN level should be the entry level for future nurses, as opposed to those already in practice. "Most nurses, who at this time cannot further their education, continue to attend CE seminars, read nursing magazines and articles and belong to professional organizations." She added that I was too harsh in questioning a nurse's commitment to the profession if advanced education was not in her immediate plans. Perhaps I was.

Agree to Disagree
About 6 weeks ago, at an ADVANCE Job Fair in Atlantic City, NJ, three RN attendees approached me to counter my position on the BSN-entry level. These veteran, diploma grads had a combined 60 or more years' nursing experience, I would guess. They presented their views clearly and without defensiveness. Each recalled clinical practice situations where, in their judgment, their decision-making and organizational abilities dwarfed those of BSN graduates. These tenacious nurses wanted to know why, even with the evidence they presented, I still thought it was important for every RN to have a BSN.

I noted that most nurse managers and administrators would agree with them that new ADN and diploma grads can run rings around BSN graduates in making the transition from student to novice nurse. However, after 9 months to a year, BSN nurses progress more quickly than their counterparts in areas such as patient teaching, critical-thinking skills in crisis situations and abilities to communicate with physicians and allied health professionals, according to these same nurse administrators and managers I have talked to over the years.

By the way, these three nurses stayed for the entire CE event that day, and call it nurse's intuition or good assessment skills, but I knew the three were all competent nurses. We agreed to disagree.

A Resource to My Rescue
Obviously, I think I have established my position about why I think a BSN degree is essential for a professional nurse in this fast-paced, high-tech world of healthcare today. Certainly, more funding must be available for students who choose nursing as a career, as well as practicing nurses who want to return to school. Also, more partnerships between ADN and BSN programs must be formed or strengthened to support and encourage students to pursue educational mobility. For those nurses who don't live near a college or university, more nontraditional educational programs must be developed.

Finally, I decided to try one more time to address those nurses who refuse to acknowledge that earning a BSN will make them better nurses. To do this, I called a credible expert, Maryellen Smith, PhD, RN,CS, assistant dean and director of undergraduate programs at Drexel University College of Nursing, Philadelphia. Dr. Smith graduated, taught and administered an associate degree program before making the transition to BSN education. As an oncology clinical specialist, this nurse has worked with graduates from all educational programs.

"To be able to keep up with new developments in healthcare today and in the future, nurses must be knowledgeable in areas such as genetics, informatics and research," Dr Smith emphasized. She noted this content is beyond the scope of a 2-year program.

"Nursing today is about evidence-based practice. For example, if a nurse is a member of a hospital's policy and procedure committee, the committee may be examining how frequently IV-tubing should be changed. Nurses must have the knowledge to collect and analyze data to develop a research-based policy," the associate dean summarized.

Kay Bensing is senior staff nurse consultant at ADVANCE.

Career Beat Archives
  Last Post: December 24, 2009 | View Comments(1)

Please help me recall first date when proposal was made for BSN to be requirement for entry into practice. If memory serves me it was 1964 and 25 years was to be given until it was to be made a regulation.
Too bad we can't get out of our own way.
Thank you.

Harriet Forman, EdD, RN Private December 24, 2009
New York, NY


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