Transitioning from ADN to BSN: A Nursing Education Plan

From ADN to BSN: The Case for Transition

While both the Associate Degree Nursing (ADN) program and the Bachelor of Science in Nursing (BSN) program lead to licensure as a registered nurse (RN), the BSN program provides nursing students with considerably more exposure to the training, knowledge, skills, and experience that prove useful in a real-world nursing environment. The ADN program, by contrast, is more limited and does not fully exploit opportunities for deepening students' knowledge of and appreciation for the nursing concepts required in today's health care industry.

For example, an ADN program does not devote as much time to the importance of evidence-based practice as a BSN program does, nor does it provide as many simulation opportunities for students to strengthen their clinical skills in a controlled environment before entering live clinical settings where decisions can be a matter of life and death. For these reasons, transitioning from an ADN program to a BSN program is the recommended route for nurses today.

Factors, IOM Guidance, and Program Barriers

Two Factors That Influence the Need for a BSN Program

Two factors that influence the need for a BSN program are social and economic, as Khawaja (2015) has noted. The social factor is the reality that BSN programs provide students with greater choice in how to apply their human capital. An ADN program offers nursing students only a limited range of career options, whereas the BSN program establishes a firm foundation upon which a policy of lifelong learning can be built.

Moreover, nurses who complete a BSN program emerge with greater range and depth of training that prepares them to provide a higher quality of life—both economically and socially—for themselves as they pursue their careers, and a higher level of quality care to a diverse patient population. A BSN program may offer courses in community nursing, pediatrics, psychosocial nursing, and related subjects, all of which give nurses better preparation for addressing the needs of patients and for building a solid base of nursing knowledge that can be used to pursue more advanced careers. Additionally, the more education an RN possesses, the more critical that RN is to a country's health: such nurses are able to offer care across a range of settings (Kirschling, 2017), thereby providing social and economic support to the nation's infrastructure (Well, 2007). Thus, both social and economic factors point to the need for BSN programs.

How the IOM Has Informed the Decision for a BSN Program

The Institute of Medicine (IOM) has informed the decision for a BSN program by promoting its "Future of Nursing" initiative, which advocates for increased education for nurses. The IOM (2010) recommends that the percentage of nurses holding a BSN reach 80% by 2020. Another goal is for the number of nurses with a PhD to double by 2020. These targets cannot be achieved without more BSN programs giving student nurses greater opportunities to advance their education.

IOM's Recommendations for Guiding the Integration of Quality and Safety Initiatives

The IOM (2010) recommends that, in order to integrate quality and safety initiatives in the BSN program, there should be greater focus on evidence-based practice, collaborative practice, teamwork, and the use of technological tools that support an environment of high-quality care. Following these recommendations, nurses are expected to practice to the full extent of their education in serving their communities and to provide safe, quality care to patients.

Rationale for the Recommendation

The IOM (2010) cites high turnover rates among nurses resulting from a lack of transition-to-practice residency programs and insufficient education and training for student nurses. ADN programs do not offer enough opportunities for nurses to prepare for the real-world challenges that await them in today's health care facilities, where patients present with a complex array of health problems. Nurses who obtain a higher level of education are better positioned to help patients with more complex issues. The more education and training a nurse receives in evidence-based practice, collaborative care, teamwork, and technology, the more likely that nurse will be to provide quality, safe care to patients regardless of their condition, and the less likely that nurse will be to commit errors on the job.

One Possible Barrier

One possible barrier to implementing the IOM's recommendations is that establishing an environment with multiple educational opportunities has been made difficult at the federal level. For example, the Federal Trade Commission (FTC) "has long targeted anti-competitive conduct in the health care market, including restrictions on the business practices of health care providers" (IOM, 2010, p. 2). The FTC must eliminate policies that restrict healthy competition in the health care field—policies that limit student nurses' options for obtaining higher levels of education and discourage professionals from pursuing pathways into nursing education. For a BSN program to operate efficiently, it requires access to a sufficient pool of nursing educators. Therefore, it is important for stakeholders at local, regional, state, and federal levels to communicate with nursing educators and nurse professionals to ensure that federal trade rules do not limit student nurses' potential. The more that nurse professionals, nurse educators, and nursing students work together to create the best possible learning environment, the more likely the IOM's recommendations are to be implemented.