There are several educational paths to become a registered nurse (RN). Currently, entry-level nurses can earn a diploma either through an Associate’s degree (ADN) or Bachelor’s degree (BSN). Beyond the entry-level, nurses can earn a Master’s (MSN) or Doctor of Nursing Practice (DNP).

The 411 on Nursing Degrees

Degree specific information was collated and reported by Medscape, a medical website resource. The following are the findings:

• 20% of the current nursing workforce initially graduated with a diploma
• Only 3.1% of RNs graduating after 2004 have earned a diploma
• 45% of RNs initially earn an ADN; ADN degrees remains the most common nursing degree
• 21% of RNs who initially earn an ADN go on to earn a BSN or higher
• A 10 1/2 year gap is the average time between a diploma or ADN graduate earning a BSN
• 50% of all RNs eventually earn a BSN
• 34% of RNs earn a BSN as their initial nursing degree
• 13.2% of licensed RNs currently hold a Master’s degree or higher

That said, what’s next for nursing education?

Projected Changes in Nursing Education

In 2009, a research study done by the Institute of Medicine, an affiliate of the National Academy of Sciences, and the Robert Wood Johnson Foundation (RWJF) in Princeton, NJ delved into the future of nursing education in the U.S. The RWJF was established by the Johnson & Johnson family and is solely dedicated to improving health and healthcare in the U.S. The study, called Future of Nursing (FON), was actually led by a nurse, Michael Bleich, RN, PhD, from the Oregon Health & Science University of Nursing.

Here are the basic results of the FON study:

• Diploma programs offer outstanding clinical experience, but should be phased out over the next 10 years
• ADNs remain important entry points for a career in nursing, but should not be terminal degrees
• Healthcare institutions should offer increased tuition reimbursement for ADN graduates to earn a BSN within 5 years of graduation
• Better patient outcomes are achieved in hospitals that employ a higher percentage of BSN graduates than ADN graduates
• BSN graduates should represent 80% of the workforce by 2020
• 10% of BSN graduates should matriculate into a Master’s or higher program within 5 years of graduation
• The American Organization of Nurse Executives and the American Association of Colleges of Nursing wants to mandate a BSN as a career entry point
• Doctoral prepared nurses should double by 2020

While this is a daunting task for the nursing profession as a whole, the core reason that nursing education needs to be completely overhauled is simply stated in one quote by the FON:

“The ways in which nurses were educated during the 20th century are no longer adequate for dealing with the realities of the 21st century.”

The How-To’s

In order to revise nursing education and accomplish the desired goals, the FON suggested three key areas that need to be addressed:

1. What to teach…an ideal nursing curriculum, including ambulatory nursing concepts
2. How to teach…methods and strategies for conveying the updated curriculum
3. Where to teach…appropriate venues for nursing education

This nursing education assessment was predicated on the premise that healthcare is trending to outside the hospital except for the critically ill and ambulatory care is widely emerging as a standard of care. It is time to revise and update our current nursing practices.