View Full Version : MSN vs. BSN as entry-level nursing PART 2

04-25-2012, 11:33 PM
(part 2)


To keep pace with the rapidly changing healthcare environment, nurse educator must continuously evaluate and revise education curricula, approaches, and programs used to educate new and practicing nurses for the high demand of healthcare today and future needs. Today, nurse’s roles have changed with the transformation of healthcare, but the level of nursing education has remained the same (Lane, & Kohlenberg, 2010).

It is important to recognize that the baccalaureate degree in nursing, as entry level, is an immediate need of the evolving complex demands of the health care field during challenging times of health care reform. According to research, the baccalaureate degree in nursing is needed for nurses to function as an equal partner in patient care (Ellenbecker, 2010). BSN-prepared nurses are fully capable to provide direct, high-quality, holistic, culturally-based and patient-centered care, therefore, meeting the requirements and the high demands of collaboration within the multidisciplinary team.

Well-educated nursing professionals are in high demand, as a result of various nursing roles in future. However, legislation for MSN as the entry-level into nursing practice cannot be properly addressed without first attending to the need for processing and legislation requirements for BSN as the entry level. Challenges for legislation BSN as entry-level are represented by following “opposing forces”: federal financing mechanisms, state practice and licensing regulations, sluggish economy with high rates of unemployment opposition from stakeholders of associate degree programs. Regardless of ANA’s position regarding BSN as entry-level into professional practice versus ADN as technical nursing practice, there are multiple ADN programs throughout the country existing in the present time, and more of them appearing.

Ellenbecker (2010) addressed the issue of the nursing shortage and emphasized the need for well-educated and prepared nurses. The author ordered immediate legislation to address requirements of BSN as the entry-level into the workforce. She supported her argument by acknowledging better patient outcomes and better professional performance carried out by BSN-prepared nurses. The need for BSN-prepared nurses also addresses the demand for graduate-prepared nurses, since BSN professionals are more likely to advance their education and career (Ellenbecker, 2010). The author discussed a small number of educated nursing professionals to fulfill the need of growing demands for graduate-level prepared professionals to meet the need for primary health care providers such as independent nursing practitioners, including mental healthcare field, researchers, and educators.

Magnet recognition requirements include the continuing of education for nurses and BSN as a necessary requirement for practicing nurses in these hospitals. It has forced many nurses to advance their degree even if it meant inconvenience of restricted time frames. Currently, many nurses fear the same would happen if legislation were to pass MSN as the entry-level. First and foremost, financial aid is a huge issue. It is not always readily available and many hospitals are not always willing to pay for advancing their workers’ degrees. Secondly, it is very challenging to balance the high demands of advancing one’s education with career, paired with continuous struggle with grades, families, and work-related requirements. Many nurses cannot see past the stress and pressure of obtaining another degree. Although nursing provides many opportunities and decent paying salaries, it is not always suitable for the nurse’s well-being. As a conclusion, BSN as the entry-level should be a choice at this time, not a requirement.

In addition, there is also a big concern about the nursing shortage. However, it is not the responsibility of the nursing profession to sell out to the business world and produce nurses who cannot represent the interests of the patients, or who cannot support the remaining healthcare team, because he/she lacks a bachelor’s degree in nursing. There are very few health professionals who have less than a bachelor’s degree. This is due to the complexities of healthcare today and because nursing requires a broad education, not just a set of skills.

An advantage of having BSN as entry-level is the advancement opportunities. It may be more limited for ADN and diploma holders, compared to RNs who obtain a BSN or higher. Bachelor's degree programs offer more clinical experience in nonhospital settings. This promotes a more liberal education and focus for students obtaining a bachelor’s degree in nursing. A liberal education is thought to provide the professional nurse with the skills needed to practice nursing, including critical thinking, effective communication, collaboration with others, appreciation of diversity, and integration of knowledge from science and humanities, in order to solve problems. Additionally, a liberal education helps BSN students make connections between prior learning and new clinical situations (DeBrew, 2010).

In short, a liberal education enhances professional practice. A liberal education is the appropriate way to prepare learners for the challenges that will be faced in the twenty-first century because it is this type of education that teaches students to communicate, interpret research, be creative, handle change, appreciate diversity, and work collaboratively. A liberal education is said to be an essential component of the preparation of professional nurses. Courses in the arts, sciences, and humanities, provide a forum for the study of values, ethical principles, and the physical world, as well as opportunities to reflect and apply knowledge gained to professional practice (DeBrew, 2010).

The additional course work enhances the student's professional development, prepares the new nurse for a broader practice, and provides the foundation for progression to advanced practice roles in nursing. In terms of doctoral preparation, nursing schools nationwide are moving to open more programs leading directly from the baccalaureate degree to doctoral degrees in response to the profession's dire need for more nurse faculty and researchers. These programs allow graduates of baccalaureate nursing programs to move quickly into graduate study. A great benefit of these programs is that they encourage strong BSN students to continue their education without long gaps between degree completions. (Raines, & Taglaireni, 2008).

Nursing ethics courses provide the opportunity for nursing students to develop critical thinking skills to deal with the dilemmas they may encounter either a student nurse or as professional nurse in the field. Future Nursing students are challenged to think and learn in a way that will prepare them for clinical practice in a complex health care environment (Raines, & Taglaireni, 2008). Although a BSN education is not a remedy for all that is expected of nurses in the future. However, it does introduce students to a wider range of competencies in such areas such as: health policy, health care financing, community and public health, leadership, quality improvement, and systems thinking. Care within the hospital continues to grow more complex as nurses have to make critical decisions associated with care for sick and frail patients. Nurses are also required to use more sophisticated, life-saving technologies, coupled with information management systems that require skills in analysis and synthesis. Care outside the hospital is becoming more complex, as well. Nurses are being called to coordinate care among a variety of clinicians and community agencies, in order to help patients manage chronic illnesses. In doing this, patients have fewer “acute” episodes and nurses are able to provide a variety of technological tools to improve the quality and effectiveness of patient care. A more educated nursing workforce would be better equipped to meet the demands of an evolving health care system. This need could be met by having BSN as an entry-level to professional nursing. Overall, the BSN is capable of using communication in delivering services to patients in need. Effective communication is culturally appropriate and involves engagement, attention, and understanding. Communication is vital to healthcare practice and is used to make an effort on healthcare issues. Communication interprets health-related information for clients, assesses client literacy, links clients with community resources, advocates for health, and disseminates knowledge related to public health issues that affect individuals, populations, and communities (Debrew, 2010).

Due to the ever-changing and challenging field of nursing there are many reasons to support a Masters of Science in Nursing degree as entry level to nursing practice. The three major reasons include increasing life expectancy with mounting complexities/acuities and the physician shortage in conjunction with the overall aging population of healthcare professionals. More qualified nurses are needed as the life expectancy and the acuity and complexity of patients continue to increase. An MSN degree better prepares nurses to more efficiently and effectively manage this more acute population.