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Nursing Education Pathways

Bachelor of Science in Nursing
Master's in Nursing
Doctoral Degree in Nursing
Accelerated Programs
Your Nursing Career

If you are considering a Bachelor of Science in Nursing, use the resources below to learn more about degree pathways, nursing programs, and accelerated programs.

THE NEED FOR THE BACCALAUREATE NURSE 

The Bachelor of Science degree in nursing is the critical first step for a career in professional nursing. The American Association of Colleges of Nursing (AACN), American Organization of Nurse Executives (AONE), American Nurses Association (ANA) and other leading nursing organizations recognize the BSN degree as the minimum educational requirement for professional nursing practice. While graduates can begin practice as an RN with an associate degree or hospital diploma, the BSN degree is essential for nurses seeking to move up the career ladder and provide a higher level of quality care. 

The BSN nurse is prepared for a broader role. The BSN nurse is the only basic nursing graduate preferred to practice in all health care settings -- critical care, ambulatory care, public health, and mental health -- and thus has the greatest employment flexibility of any entry-level RN. The BSN curriculum includes a broad spectrum of scientific, critical-thinking, humanistic, communication, and leadership skills, including specific courses on community health nursing not typically included in diploma or associate-degree tracks. These abilities are essential for today's professional nurse who must be a skilled provider, designer, manager, and coordinator of care. Nurses must make quick, sometimes life-and-death decisions; understand a patient's treatment, symptoms, and danger signs; supervise other nursing personnel; coordinate care with other health providers; master advanced technology; guide patients through the maze of health resources in a community; and teach patients how to comply with treatment and adopt a healthy lifestyle.

In particular, a report by the National Advisory Council on Nurse Education and Practice, an advisory panel to the federal Division of Nursing, noted that baccalaureate nursing programs are far more likely than other entry-level tracks to provide students with on-site clinical training in non-institutional settings outside the hospital. As a result, the BSN graduate is well-prepared for practice in such sites as home health agencies, outpatient centers, and neighborhood clinics where opportunities are fast expanding as hospitals focus more on acute care and health services move beyond the hospital to more primary and preventive care throughout the community.

The BSN nurse is preferred. More nurse executives are indicating their desire for the majority of their hospital staff nurses to be prepared at the baccalaureate level to meet the more complex demands of today's patient care. In fact, the words "BSN preferred" are appearing more frequently in classified ads for registered nurses nationwide.

Aware of the expanding opportunities, RNs are seeking the BSN degree in increasing numbers. In 1980, almost 55 percent of registered nurses held a hospital diploma as their highest educational credential, 22 percent held the bachelor's degree, and 18 percent an associate degree, according to figures from the federal Division of Nursing. By 2008, a diploma was the highest educational credential for only 13.9 percent of RNs, while the number with bachelor's degrees had climbed to 36.8 percent, with 36.1 percent holding an associate degree. In addition, 13.2 percent of the current nursing workforce hold master's or doctoral degrees. According to a report released by the Health Resources and Services Administration in July 2002, associate degree in nursing graduates are declining at a somewhat faster rate than baccalaureate graduates, with the net result that baccalaureate graduates now comprise an increasingly greater share of total graduates. These numbers indicate the high premium that nurses place on advanced education in today's growing market, and the demand by employers for RNs who are baccalaureate-prepared. 

RN to BSN 

If you already hold your RN and would like to advance your education, access the Academic Progression Brochure for more information on the opportunities available to you. 

ADVANCED PRACTICE NURSING: EXTENDING PRIMARY CARE'S REACH

The health system's increasing demand for front-line primary care, and the accelerating drive toward managed care, prevention, and cost-efficiency, are driving the nation's need for nurse practitioners, clinical nurse specialists, certified nurse-midwives, and other RNs with advanced practice skills.

Prepared typically in graduate programs, advanced practice nurses (APNs) include the following four categories of clinicians: 

Nurse Practitioners (NPs) conduct physical exams; diagnose and treat common acute illnesses and injuries; provide immunizations; manage high blood pressure, diabetes, and other chronic problems; order and interpret X-rays and other lab tests; and counsel patients on adopting healthy lifestyles and health care options as a part of their clinical roles. In addition to practicing in clinics and hospitals in metropolitan areas, the nation's estimated 158,348 nurse practitioners also deliver care in rural sites, inner cities, and other locations not adequately served by physicians, as well as to other populations, such as children in schools and the elderly. Many NPs work in pediatrics, family health, women's health, and other specialties, and some have private practices. Nurse practitioners can prescribe medications in all states, while 23 states have given NPs authority to practice independently without physician collaboration or supervision.

Clinical Nurse Specialists (CNSs) provide care in a range of specialty areas, such as cardiac, oncology, neonatal, and obstetric/gynecological nursing, as well as pediatrics, neurological nursing, and psychiatric/mental health. Working in hospitals and other clinical sites, CNSs provide acute care and mental health services, develop quality assurance procedures, and serve as educators and consultants. An estimated 59,242 clinical nurse specialists are currently in practice.

Certified Nurse-Midwives (CNMs) provide prenatal and gynecological care to normal healthy women; deliver babies in hospitals, private homes, and birthing centers; and continue with follow-up postpartum care. In 2002, CNM deliveries accounted for 8.1 percent of all births in the U.S., up from 6.5 percent in 1996, according to the National Center for Health Statistics. There are approximately 18,492 CNMs nationwide.

Certified Registered Nurse Anesthetists (CRNAs) administer more than 65 percent of all anesthetics given to patients each year, and are the sole anesthesia providers in approximately two-thirds of all rural hospitals in the U.S., according to the American Association of Nurse Anesthetists (AANA). Of the 24 million anesthetics given annually, about 20 percent are administered by CRNAs practicing independently and 80 percent by CRNAs in collaboration with physician anesthesiologists, says AANA. Working in the oldest of the advanced nursing specialties, CRNAs administer anesthesia for all types of surgery in settings ranging from operating rooms and dental offices to outpatient surgical centers. There are more than 34,821 CRNAs in practice nationwide.


Mounting studies show that the quality of APN care is equal to, and at times better than, comparable services by physicians, and often at lower cost. 

For example, Even after acknowledging flaws in some of the studies it reviewed in 1986, the congressional Office of Technology Assessment (OTA) concluded that nurse practitioners can deliver as much as 80 percent of the health services, and up to 90 percent of the pediatric care, provided by primary care physicians, at equal or better quality and at less cost. In the 12 studies reviewed, OTA found that the quality of care by nurse practitioners -- including communication with patients, preventive actions, and reductions in the number of patient symptoms -- was higher than comparable care by physicians. 

At the University of Rochester, researchers reported that intensive-care babies cared for by neonatal nurse practitioners averaged 2.4 fewer hospital days and more than $3,400 less in charges than those cared for by medical residents, despite the fact that the NPs' infants were younger and had significantly lower birthweight. Unlike residents, nurse practitioners don't rotate, are "more consistent caregivers" who can follow infants through their entire stay, and need to rely less on support services to stay apprised of a patient's progress, the authors suggest in the 1994 study.

With an increasing emphasis on preparing nurses at the baccalaureate and higher degree level, one innovative approach to nursing education that is gaining momentum is the accelerated degree program for non-nursing graduates. These programs build on previous learning experiences and provide a way for individuals with undergraduate degrees in other disciplines to transition into nursing.

Program Basics

  • Accelerated baccalaureate programs offer the quickest route to licensure as a registered nurse (RN) for adults who have already completed a bachelor’s or graduate degree in a non-nursing discipline. 

  • Fast-track baccalaureate programs take between 11 and 18 months to complete, including prerequisites. Fast-track master’s degree programs generally take about 3 years to complete. 

  • Accelerated nursing programs are available in 47 states plus the District of Columbia, the Virgin Islands, and Guam. In 2016, there were 272 accelerated baccalaureate programs and 69 accelerated or entry-level master’s programs available at nursing schools nationwide. In addition, 24 new accelerated baccalaureate programs are in the planning stages, and 9 entry-level master's programs are also taking shape. To locate accelerated programs near you, see www.aacnnursing.org/about-aacn/member-directory.

 

Fast-Track Nursing Education

  • Accelerated baccalaureate programs accomplish programmatic objectives in a short time by building on previous learning experiences. Instruction is intense with courses offered full-time with no breaks between sessions. Students receive the same number of clinical hours as their counterparts in traditional entry-level nursing programs.

  • Admission standards for accelerated programs are high with programs typically requiring a minimum of a 3.0 GPA and a thorough pre-screening process. Identifying students who will flourish in this environment is a priority for administrators. Students enrolled in accelerated programs are encouraged NOT to work given the rigor associated with completing degree requirements.

  • Accelerated baccalaureate and master’s programs in nursing are appropriately geared to individuals who have already proven their ability to succeed at a senior college or university. Having already completed a bachelor’s degree, many second-degree students are attracted to the fast-track master's program as the natural next step in their higher education.

Read Issue Bulletin - Accelerated Program The Fast Track to Careers in Nursing

 

Accelerated Program Graduates
  • The typical second-degree nursing student is motivated, older, and has higher academic expectations than traditional entry-level nursing students. Accelerated students excel in class and are eager to gain clinical experiences. Faculty find them to be excellent learners who are not afraid to challenge their instructors.

  • Graduates of accelerated programs are prized by nurse employers who value the many layers of skill and education these graduates bring to the workplace. Employers report that these graduates are more mature, possess strong clinical skills, and are quick studies on the job.

  • AACN's 2016 survey found that 17,725 students were enrolled in accelerated baccalaureate programs, which represents an increase from 2015 when 16,662 students were enrolled. The number of program graduates has increased from 11,071 in 2015 to 11,823 in 2016. In entry- level master's nursing programs, 6,991 students were enrolled and 2,375 students graduated in 2016. By comparison, in 2015, there were 6,126 students enrolled and 2,378 graduates from these programs.

  • Given their experience and level of educational achievement, many graduates of accelerated master’s programs are being encouraged to pursue roles as nurse educators to help stem the growing shortage of nurse faculty.
Supporting Accelerated Programs

  • Financial aid for students enrolled in accelerated baccalaureate and master’s programs in nursing is limited. Many practice settings are partnering with schools and offering tuition repayment to graduates as a mechanism to recruit highly qualified nurses.

  • Hospitals, health care systems, and other practice settings are encouraged to form partnerships with schools offering accelerated programs to remove the student's financial burden in exchange for a steady stream of new nurse recruits. Nurse employers including Tenet Healthcare, Carondelet Health Network, University of Missouri Health Care, North Carolina Baptist Hospital, Duke University Health System, and many others are actively supporting the development and growth of accelerated baccalaureate programs in nursing.

  • Legislators on the state and federal levels are encouraged to increase scholarship and grant funding for these programs that produce entry-level nurses faster than any other basic nursing education program. These programs are ideal career transition vehicles for those segments of the labor force impacted by fluctuations in the economy.

 


A LOOK AT THE FACTS:

Nursing is the nation's largest health care profession with more than 3.1 million registered nurses practicing nationwide. Despite its large size, many more nurses are needed into the foreseeable future to meet the growing demand for nursing care.

As you plan or consider a career as a registered nurse, you should know these facts:

    • The U.S. Bureau of Labor Statistics projects that employment for registered nurses will grow faster than most other occupations through 2018.

    • Nursing students comprise more than half of all health professions students.

    • Nurses comprise the largest single component of hospital staff, are the primary providers of hospital patient care, and deliver most of the nation's long-term care. 

    • Most health care services involve some form of care by nurses. Although 62.2 percent of all employed RNs work in hospitals, many are employed in a wide range of other settings, including private practices, public health agencies, primary care clinics, home health care, outpatient surgicenters, health maintenance organizations, nursing school-operated nursing centers, insurance and managed care companies, nursing homes, schools, mental health agencies, hospices, the military, and industry. Other nurses work in careers as college and university educators preparing future nurses or as scientists developing advances in many areas of health care and health promotion.

    • Though often working collaboratively, nurses do not simply "assist" physicians and other health care providers. Instead, they practice independently within their own defined scope of practice. Nursing roles range from direct patient care to case management, establishing nursing practice standards, developing quality assurance procedures, and directing complex nursing care systems. 

    • With more than four times as many RNs in the United States as physicians, nursing delivers an extended array of health care services, including primary and preventive care by advanced, independent nurse practitioners in such clinical areas as pediatrics, family health, women's health, and gerontological care. Nursing's scope also includes care by clinical nurse specialists, certified nurse-midwives and nurse anesthetists, as well as care in cardiac, oncology, neonatal, neurological, and obstetric/gynecological nursing and other advanced clinical specialties. 

    • The primary pathway to professional nursing, as compared to technical-level practice, is the four-year Bachelor of Science degree in nursing (BSN). Registered nurses are prepared either through a four-year baccalaureate program; a three-year associate degree in nursing program; or a three-year hospital diploma program. Graduates of all three programs take the same state licensing exam, the NCLEX-RN. (The number of diploma programs has declined steadily -- to less than 10 percent of all basic RN education programs -- as nursing education has shifted from hospital-operated instruction into the college and university system.)