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.
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.