Do Hospital Employers Prefer BSN Nurses to ASN or Diploma Nurses?

The debate over whether hospital employers prefer Bachelor of Science in Nursing (BSN) graduates, Associate Degree in Nursing (ASN), or Diploma programs has been contentious. While some nursing communities believe that a four-year degree is necessary for quality care, others argue that competence and passing national boards are the most important factors.

Misconceptions and True Facts

Several misconceptions have led to the belief that BSN degrees are essential for improving hospital quality. One of the commonly cited reasons is the desire for Magnet Status, which is believed to distinguish hospitals from one another in terms of nursing staff quality. However, this belief is debased by evidence and reasoning.

The Basis of Magnet Status

The initial research that purported to show a correlation between mortality rates and educational levels of nurses was flawed. The researchers found that ICUs were mostly staffed by nurses with Associate Degree and Diploma educations. Thus, it was concluded that patients were at higher risk with less educated nurses. This skewed the perception and subsequently spurred a campaign for BSN employees, forming the basis for Magnet Status.

Flawed Assumptions and Results

In reality, as more BSN nurses entered ICUs, the quality of patient care did not necessarily improve. In fact, there is evidence indicating that a patient is more likely to die with the care of a BSN nurse than with an ASN or Diploma nurse. This is due to the overstaffing of BSN nurses in administrative roles, which reduces the number of bedside nurses available to patients.

The Financial and Logistical Impact

The emphasis on requiring all staff with less than a BSN to obtain higher credentials within three years has led to a shortage of bedside nurses. This shortage has driven up the demand for registered nurses in temporary positions (travelers). Moreover, Magnet Status hospitals are not reimbursed any differently from non-Magnet status hospitals, making the initiative financially unviable for many healthcare institutions.

The Personal Perspective

Prior to my decision to opt for an ASN degree, I initially believed that a four-year BSN would be the optimal route. My decision was also influenced by the belief that direct patient care is more meaningful than administrative roles. Working three days a week, I enjoy a significant amount of free time, which I did not have when working in more demanding roles in the ICU or as a middle manager.

Conclusion

The preference for BSN nurses over ASN or Diploma nurses should be based on competence and clinical expertise rather than the educational background alone. Hospital leaders would do well to focus on ensuring that all nurses, regardless of their educational pathway, have the skills and knowledge required to provide the best possible care to patients. The emphasis on administrative roles and Magnet Status should be reconsidered to address the real issues in healthcare delivery.