To Promote RN-to-BSN Achievement, Standardize Requirements

To simplify the process by which registered nurses attain Bachelor of Science in nursing degrees, the Robert Wood Johnson Foundation recommends that nursing schools adopt standardized non-nursing course requirements.

If you want to get a group of nurses fired-up, ask them if a baccalaureate degree should be the minimal degree required to practice nursing. You won't get a collective yes or no answer, and there will be a division between BSN-proponents and those who feel an associate's degree in nursing is perfectly acceptable.

At least that's been my experience as a staff nurse, nurse manager, and nurse editor. Those in favor of the BSN point to decades of research that show patient outcomes improve with care from BSN-prepared RNs.

It's hard to argue with data, but I've still seen many ADNs become highly upset by the implication that a BSN should become the standard for the profession. I began my nursing career with a BSN, but I understand, in some respects, why so many ADNs respond the way they do. It's a lot of pressure to be told you have to go back to school in order to continue in your profession.

For those who entered nursing 20 or 30 years ago, it feels like the rules are suddenly being changed mid-game. They can't understand why after providing patient care for all these years they're now being told their education is not good enough to do the job they've been doing for decades.

In addition, if this is not something they planned for financially, coming up with tuition can be a legitimate barrier. And, for those with families, finding time to dedicate to school may difficult. Even if they may want to go back to school, it's not always an easy goal to achieve.

Others in the nursing profession recognize legitimate hurdles to the RN-to-BSN process as well. That's why a group of nurse leaders and educators backed by the Robert Wood Johnson Foundation gathered to identify barriers to academic progression and to find ways to overcome them.

As a result of their work, they are calling on nursing education programs to adopt a standardized set of non-nursing course requirements to help facilitate RN-to-BSN completion.

Making a Plan and Moving Forward
As it stands now, admission criteria, course requirements, and transferable academic credits vary from nursing school to nursing school. This lack of consistency extends the time and increases the expense it takes for an RN to earn his or her BSN.

This was a known issue to members of the group says Tina Gerardi, MS, RN, CAE, deputy director, national program office, academic progression in nursing at the American Organization of Nurse Executives. Instead of rehashing old issues, they decided to come up with solutions to the inconsistency in education requirements in the hopes of simplifying academic progression in nursing.

"In March 2014, we had a 'moving forward meeting,'" says Gerardi. "It was a national meeting looking at barriers to academic progression and what could be done at a national level to either alleviate [or] remove those barriers."

At the end of the meeting, it was determined that the next steps should be taken at a national level to be of most assistance to all involved.

"The one thing that came out of that [meeting] was to look at general education and prerequisite requirements for nurses going on for a baccalaureate degree," she says. "We know students are repeating courses, and people talk about how they've changed schools and taken chemistry three times."

To figure out where the inefficiencies were, a smaller work group compared samples of RN-to-BSN programs and generic baccalaureate programs.

"When we looked at the RN-to-BSN, it all over the map in terms of number of credits," Gerardi says. "So that's where we really concentrated our time and looked at that."

Building a Foundation
The group decided to focus its efforts on foundational non-nursing courses and determine the number of credits that should be included in the prerequisites and what types of courses the students should be taking. They agreed a bachelor's degree should be between 120 and 128 credits to allow for faculty independence and to help meet state- or school-specific mandates.

The recommendations were broken down into categories and the number of credits in each category was determined. They also gave examples on types of courses that should be included. The recommendations were approved by the larger group.

The newly recommended BSN foundational courses consist of the following 60 to 64 non-nursing credits:

• Approximately 24 general education credits in areas such as communications, English, humanities and the fine arts, statistics, and logic;
• About 12 basic sciences credits in areas such as chemistry, biology, microbiology, and physics;
• Roughly nine social sciences credits in areas such as growth and development, psychology, and sociology;
• Approximately 16 human sciences credits in areas such as anatomy and physiology, pathophysiology, nutrition, and pharmacology

"Now we've just been pushing it out, distributing it, and asking schools to take a look at what they have," Gerardi says. "It's the first time any kind of consensus has been pushed out there for folks to take a look at or start with as they are putting together these programs."