Blog » BSN Boost: Money Maker or Life Saver?

BSN Boost: Money Maker or Life Saver?

Created Aug 25 2014, 08:00 PM by Lippincott Solutions
  • new nurse
  • BSN
  • IOM
  • Institute of Medicine
  • RN-to-BSN
  • veteran nurses
  • experienced nurse
  • AACN

Tuesday, August 26, 2014

Four years after the Institute of Medicine’s (IOM) October 2010 call to ramp up the population of BSN-prepared nurses to 80% of the nursing workforce by 2020, RN-to-BSN programs are booming. Today, more than 690 such programs exist around the country. The number of nurses pursuing a BSN has hit more than 100,000—compared to just 35,000 a decade ago.

Those who initially dismissed the IOM recommendation as pie-in-the-sky saw it hit closer to home when, in 2013, the American Nurses Credentialing Center began requiring Magnet applicants to document their progress toward achieving an 80% BSN-prepared nursing staff at their hospitals.

No surprise, hospitals reacted. An American Association of Colleges of Nursing (AACN) survey conducted in August 2013 found that more than 78% of hospitals and other healthcare settings expressed a strong hiring preference for BSN-prepared nurses. Nearly 44% went a step further and said they required new hires to hold a BSN. Hospitals like Saint Peter’s University Hospital in New Brunswick, NJ, even adopted policies requiring all RN employees to earn a BSN within the next decade—or lose their jobs.

Formal vs. Informal Education

Unlike past calls to establish the BSN as the entry into nursing practice, this BSN push packs power. Across the United States, diploma- and ADN-prepared nurses—and, if they’re lucky, the hospitals that employ them—are shelling out significant bucks to advance their nursing education and collect their BSN. But is the focus on costly formal education discounting the know-how veteran nurses have already obtained through decades of on-the-job experience and professional continuing education?

Some think so, calling it nothing but a higher ed. ploy for colleges and universities to earn more money. (The American Association of Colleges of Nursing was among the organizations on the Tri-Council for Nursing that, in May 2010, supported a more highly educated nursing workforce.) Others see it as a bias against aging nurses whose future plans once revolved more around retirement than returning to school.

“This entire argument frustrates me to no end. It seems to be a process of weeding out the older nurses who may have hospital diploma or ADN degrees,” wrote one nurse. “We need experienced nurses who can care for the patients and do what is required to get the patient better. In my experience, the hospital-diploma trained nurse of years gone by has always been the best trained nurse.”

What the Newest Research Says

Recent research begs to differ.  

Adding to previous studies that, in part, fueled the IOM to make its BSN recommendation, are three new papers published within the last year or two. University of Pennsylvania professor Linda H. Aiken, PhD, RN, FAAN, and University of Michigan associate professor Olga Yakusheve, PhD, reviewed the studies in an Oct. 10 post on the Robert Wood Johnson Foundation blog, and these are the findings in a nutshell:

  • Pennsylvania hospitals that increased their percentage of BSN-prepared nurses between 1999 and 2007 saw declines in patient mortality that were significantly greater than declines at hospitals that had not. Had all Pennsylvania hospitals employed an 80% BSN-prepared RN workforce, researchers estimate, some 2,100 lives may have been saved during those years.
  • For every 10% increase in the number of BSN-prepared nurses in European hospitals, there was a 7% drop in patient mortality following common surgical procedures.
  • When patients received 80% of their care from BSN-prepared nurses, readmission rates and average length of stay dropped significantly.

Experience and Education Mix

"As BSN rates go up, patient outcomes improve," Cheryl Saffer, coordinator of clinical education and nursing research at BSN-believing Saint Peter’s University Hospital, told The Star-Ledger.

As the newspaper observed, veteran nurses, initially shocked they had to earn a BSN, have accepted the turn-of-events and are finding their RN-to-BSN coursework interesting. Still, many are not convinced the classes will actually make them better nurses.

 “It is simply ridiculous to compare nurses with different educational backgrounds to see who makes a better nurse,” mused an online commenter. “Experience counts, so does knowledge. You need both.”

For more information on how academic educators and healthcare institutions can work together to prepare tomorrow's nursing workforce while improving retention and patient care, click here to download our FREE White Paper entitled "New Nurse Preparedness: Perceptions From School and Practice.