The diploma nurse and the associate-degree nurse (ASN) receive essentially the same education. Diploma nurses get their professional entry-level training at a hospital-based nursing school, after which they may take the NCLEX-RN examination and apply for a license as a Registered Nurse (RN). Both diploma programs and ASN programs take about two years. While the number of nursing schools based in hospitals has decreased, but they do still exist. Some require applicants to complete their non-nursing educational prerequisites at other schools before admission.
The Associate Degree in Nursing (ADN) is also an entry-level nursing degree, and it can usually be earned at a community college. Students who complete the ADN courses may also take the NCLEX-RN license examination. Recently, some hospital-based nursing programs have changed their course offerings to provide the ADN instead of the diploma.
The debate about whether a diploma or ADN nurse should go for the BSN has been going on since professional authorities suggested the BSN as a prerequisite for professional nursing practice in 1923. Diploma nurses and ADNs have always been very proud of their accomplishments and skills and often state that they know more about actual patient care and clinical procedures than any new BSN graduate!
However, the professional landscape for nurses has changed. The health care field is becoming more complex and technology-oriented, and there is a trend toward placing more responsibility on the shoulders of nurses. Health care is moving from a primarily hospital-centered inpatient institution to a system focused increasingly on primary and preventive care in the community. Particularly at the entry level, a nurse needs more skills in community-based primary care, health promotion, and coordinate, cost-effective patient care.
This means that nurses must be able to function professionally both in and beyond the hospital setting. They may need to practice their profession in many different facilities, make more clinical decisions, handle case management, supervised unlicensed health care aides, and educate patients about complicated health issues. Modern nurses need to be more confident about their abilities and more independent in their decision-making than nurses in the past.
As a result, nurses who have earned the BSN degree are better prepared to meet the needs of the modern nursing profession. The major difference between the diploma nurse or ADN and a BSN is the latter’s focus on leadership and management education and on community-based nursing. BSN degree programs prepare students to handle health promotion, prevention of disease, disease management, and patient education. As the health care field moves further and further into these areas, the demand for professionals with the BSN degree increases.
The BSN degree provides nurses with many more career advancement opportunities – and higher pay – than the diploma or ADN degrees. The health care industry faces a growing demand for nurses on the front lines of primary care, managed care, and cost-effective care. While every diploma nurse or ADN need not pursue the BSN degree – and at the initial stages of a nursing career, the benefits of the BSN may not be apparent – more education will lead to more responsibility, higher standing in the profession, and more opportunities for career advancement and higher salaries. Some states are already requiring a BSN degree for all new hires, and some industry observers believe that the diploma and ADN programs will eventually disappear altogether.
It’s possible for working nurses to earn a BSN without taking time away from their current jobs or sacrificing their regular income by enrolling in accredited online RN-to-BSN programs. And often, a current employer may provide education benefits that can be applied to cover the costs of these programs. Many four-year nursing school programs offer “fast-track” programs that allow practicing nurses with the diploma or ADN to get a Bachelor of Science in Nursing (BSN) in about two years.
Practicing nurses must adapt to changes in the health care industry, and the best way to prepare for future changes is to obtain additional skills and more education.