BSN Degree: Pathway to Professional Nursing
This paper examines the three traditional pathways to registered nurse (RN) licensure in the United States — the hospital diploma, the two-year associate degree, and the four-year Bachelor of Science in Nursing (BSN) — and argues that the BSN represents the minimum standard for professional nursing practice. Drawing on the American Nurses Association's landmark 1965 position statement, Institute of Medicine recommendations, and research on medication error rates, the paper traces the historical shift away from hospital-based apprenticeship training toward academically grounded nursing education. It also weighs the financial and career trade-offs between associate and baccalaureate programs, ultimately concluding that the BSN is the appropriate foundation for nurses seeking leadership, research, and advanced practice roles.
- Introduction: RN Licensure Pathways in the United States: Overview of three RN pathways and thesis
- The Diploma Pathway and the ANA's 1965 Position: History of hospital diploma programs and ANA policy shift
- Two-Year Associate Degree Programs: Growth and community focus of associate degree programs
- The BSN Pathway and Professional Development: BSN curriculum requirements and workforce statistics
- BSN Pros and Cons: Education, Safety, and Cost: Research, IOM recommendations, salary and cost trade-offs
✍️ How to write this paper — guide, tools & examples ▾
What makes this paper effective
- It grounds its argument in documented policy history, tracing the ANA's 1965 position statement through to the IOM's 2010 recommendations, giving the argument a coherent chronological spine.
- It fairly acknowledges the financial and practical advantages of associate degree programs before reaffirming the BSN as the professional standard, lending the essay intellectual honesty.
- It incorporates quantitative evidence — medication error studies, enrollment statistics, tuition cost comparisons, and salary data — to substantiate claims rather than relying on assertion alone.
Key academic technique demonstrated
The paper uses a compare-and-contrast structure within a policy-argument framework. Rather than simply advocating for the BSN, it methodically evaluates each pathway on its merits, then synthesizes research findings and professional recommendations to build a cumulative case. This technique — presenting competing evidence before resolving it — is especially effective in health-policy writing.
Structure breakdown
The essay opens with a brief framing section establishing the three RN pathways and a thesis. It then moves chronologically through the diploma era and the ANA policy shift, transitions to associate degree programs, and proceeds to BSN curriculum requirements. The final section weighs pros and cons using salary data, error-rate research, and IOM targets, closing with practical guidance for prospective nursing students.
Introduction: RN Licensure Pathways in the United States
There are three traditional pathways to becoming a registered nurse (RN) in the United States: a diploma conferred by hospital programs, a two-year associate degree typically offered through community colleges, and a baccalaureate degree (BSN) offered by many four-year colleges and universities (Raines and Taglaireni, 2008). All three pathways allow graduates to sit for the NCLEX-RN exam, thereby becoming licensed to practice nursing in the United States. As of 2007, 3.1%, 38.4%, and 58.4% of newly licensed RNs chose the diploma, associate degree, or BSN pathway to licensure, respectively. This essay examines these RN pathways and argues for a greater representation of BSN-educated nurses in the healthcare field in order to improve the quality of patient care.
The Diploma Pathway and the ANA's 1965 Position
Becoming an RN through the diploma program is comparable to apprenticeship programs for carpenters and plumbers, though hospital-based programs may require completion of additional coursework at nearby academic institutions (Raines and Taglaireni, 2008). An actual degree is not conferred, yet close to 25% of RNs in practice today chose a diploma pathway to licensure.
The diploma pathway has historically been discouraged by professional medical organizations, which explains why only 3.1% of newly licensed RNs choose this route. In 1965, the American Nurses Association (ANA) published an official position on nursing education (Donley and Flaherty, 2002). This position defined two categories considered important for nursing professionals: a technical education and a professional education. The technical education could reasonably be obtained through a two-year associate degree program for those interested in patient care only, but for those with broader career aspirations, the recommended route was an academic course of study leading to a BSN. The BSN degree would confer both the technical and professional competencies needed by career-minded nurses. Notably, the ANA deemed these two degrees the minimum necessary for each respective career path, and rejected the diploma pathway as adequate preparation for RNs as early as 1965. This policy position shifted the focus of nursing education away from apprenticeships and toward academic pathways for licensure.
The ANA's 1965 position was a direct response to hospital nursing schools producing nurses to meet their own labor demands without adequate attention to students' educational needs or patient safety (Donley and Flaherty, 2002). Attending lectures was often impossible given the workloads placed on students, who were typically required to work between 24 and 30 hours per week. Students in diploma programs became well-versed in caring for seriously ill and hospitalized patients, but by today's standards this would be considered a limited education.
The breadth of training available in academic nursing programs was similarly narrow in 1965, with three-quarters of these degree programs emphasizing the roles nurses would play in caring for hospitalized patients (Donley and Flaherty, 2002). However, only 63% of practicing nurses in 1965 worked in hospitals, despite 75% to 85% having received training in a diploma program. A 1966 report noted that three years earlier there had been 818 hospital programs generating 75% of newly licensed RNs, compared to 324 academic programs producing the rest. Because the majority of nursing graduates were products of hospital programs, hospitals played an influential role in defining the nurse's role. The ANA's 1965 position was one of the first major steps in the effort to create an autonomous nursing profession.
The visionaries behind this policy shift could see how patient care benefits when professional nurses make their own independent contributions (Donley and Flaherty, 2002). Rather than simply providing trained labor to care for hospitalized patients and serve as assistants to physicians, the ANA committee envisioned a future in which the nursing profession would establish its own standards of care, grounded in an accumulated knowledge base and findings from nursing research. Professional nurses, trained at academic institutions, would help usher in evidence-based patient care.
Two-Year Associate Degree Programs
With the near-complete demise of the diploma pathway to RN licensure, a greater need emerged for a fast and cost-efficient way for nursing students to obtain the training and education required to provide quality care (Raines and Taglaireni, 2008). In 2008, approximately 940 programs offered a two-year degree in nursing, and close to two-thirds of these were based in community colleges. Such programs tend to be more responsive to the full range of nursing needs within a community, rather than focusing solely on caring for hospitalized patients.
The BSN Pathway and Professional Development
BSN programs are offered at four-year academic institutions and provide the education and training necessary to prepare nursing students to become nursing professionals (Raines and Taglaireni, 2008). These programs are typically structured to prepare students to work in diverse healthcare settings, including hospitals, and to become leaders in their profession. To achieve these goals, BSN programs demand a deeper and more thorough understanding of the sciences, nursing research, public health, healthcare management, and the humanities. In 2008, 31% of the nursing workforce had earned a BSN, and there were 606 academic BSN programs in existence.
References
Ashford, Ellie. (2011, March 28). Data show value of associate degree RN programs. Community College Times.
Blegen, Mary A., Vaughn, Thomas E., and Goode, Colleen J. (2001). Nurse experience and education: Effects on quality of care. Journal of Nursing Administration, 31(1), 33–39.
Chang, Yun-Kyung and Mark, Barbara A. (2009). Antecedents of severe and nonsevere medication errors. Journal of Nursing Scholarship, 41(1), 70–78.
Donley, Rosemary and Flaherty, Mary Jean. (2002). Revisiting the American Nurses Association's first position on education for nurses. Online Journal of Issues in Nursing, 7(2).
IOM (Institute of Medicine). (2010). The future of nursing: Focus on education. Institute of Medicine.
Kingkade, Tyler. (2013, January 9). Two-year degrees vs. four-year degrees: Sometimes associate's beats bachelor's in earning potential. Huffington Post.
Raines, C. Fay and Taglaireni, M. Elaine. (2008). Career pathways in nursing: Entry points and academic progression. Online Journal of Issues in Nursing, 13(3).
Create your account
Always verify citation format against your institution’s current style guide requirements.