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April 21, 2017

Ask Nurse Keith: ADN or BSN?

By Keith Carlson, BSN, RN, NC-BC

As a career coach for nurses, I’m often asked very similar questions by many nursing professionals. Our challenges may feel unique to us, but you can often find other nurses who feel just like you do. In other words, you’re not alone, nurses -- many of our struggles are universal. 

When you’ve decided to become a nurse after working in a different industry, it’s hard to know where to begin. As a novice in the nursing world, how do you decide which “gate” to walk through in order to get started? 

Here’s an email I received about this very subject: 

Dear Keith, 

I’ve worked in the advertising and publishing world for about 15 years, and I’ve decided to become a nurse. I’m taking Chemistry and Microbiology (God help me!), and I’ll begin applying to nursing schools in the next six months. 

Getting an ADN seems like a very affordable educational path through a local community college, but I hear that many hospitals will only hire nurses with a BSN. The BSN is more expensive and will take more time, but I wonder if it’s worth pursuing so that I have more options. 

Thanks for any light you can shed on this puzzle. 

Signed, 

ADN or BSN


Dear ADN or BSN, 

Your question is a common one, and being confused is normal.

As you likely already know, graduates from ADN and BSN programs must all pass the NCLEX exam in order to become a licensed RN. Reports by the Bureau of Labor Statistics don’t differentiate between RNs with a BSN or ADN in terms of salaries and job growth, so that data is no help in this regard. 

In 2010, the Institute of Medicine (IOM) published a report entitled The Future of Nursing: Leading Change, Advancing Health. The report recommends that 80% of RNs have a BSN by 2020. Although that process has begun, few nursing leaders seem to believe that the IOM’s ambitious goal will be met. 

Having said that, many hospitals have taken the IOM at their word. In fact, some facilities will no longer hire ADNs at all. While this can feel frustrating and unfair for those who don’t yet have a BSN, it seems that the clock can’t be turned back. 

Here are some factors to weigh when you’re researching this decision:

Assess Your Finances 

Consider your financial situation in terms of the relative cost of a BSN or ADN. A BSN will take slightly longer. Will you need to work while you’re school? 

Also calculate the cost of earning a BSN later on in your career if you choose to get your ADN first. 

Know Your Choices

  • If you’re driven to work in the acute care hospital setting, some doors will only open if you have a BSN. 
  • If you eventually want to earn a graduate or post-graduate degree, there are “bridge” programs for those with an ADN or a BSN. 
  • For individuals with a bachelor’s degree in another discipline, so-called “accelerated generalist” or “second bachelor’s” programs will accept many of your previous humanities and general education course credits, leaving you with mostly nursing courses to complete (as well as any science or math you’re missing). 
  • If you choose to earn an ADN first, you can return to school for an “RN to BSN” program, which will usually taken 12 to 18 months. The benefit of this path is being able to enter the profession more quickly through an ADN program, and then work as a nurse while earning your BSN.
     
  • Some nurses feel that associate degree programs offer more clinical experience than bachelor’s degree programs. On the other hand, some feel that the training and education in leadership, communication, humanities, and research in a BSN program makes for more well-rounded clinicians. 

Either Choice Will Work

In the end, either educational path will allow you to practice as a nurse. But as you can see, each has potential limitations to bear in mind. 

If you need the most affordable, efficient runway to an entry-level nursing career, an Associate’s Degree in Nursing will get you into the workforce relatively faster. But if you already have a bachelor’s degree in another discipline, you may find a “second bachelor’s” program to be the best choice. 

Whichever path you choose, the final result will be entry into a growing profession with unlimited potential and possibilities. Choose a path, apply yourself to your education, and keep moving towards your goal of becoming a nurse. 

All the best, 

Nurse Keith



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Keith Carlson, BSN, RN, NC-BC is a Board-Certified Nurse Coach, award-winning blogger, nurse podcaster, speaker, and author. Based in Sante Fe, New Mexico, Nurse Keith’s work has appeared in a variety of online and print publications.

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