To become a licensed registered nurse in the United States, candidates must earn a diploma from an approved nursing program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.). As of 2011 there are no states in which a B.S.N. is a requirement for nursing; however, legislation requiring that nurse practitioners hold a bachelor's degree has been proposed in several states.
While the diploma in nursing, the Bachelor of Science degree in nursing and the associate degree in nursing all qualify a candidate for licensure, there are distinct differences in the programs: nursing diplomas are usually awarded by hospitals, an associate degree is granted by a two-year community or junior college, and a bachelor's degree is earned at a four-year university. There is much debate about the merits of each program, with many people believing that only a B.S.N. degree adequately prepares future nurses. Others point out that diploma and A.D.N. holders tend to receive more hands-on experience during their education.
In 1923 the Goldmark Report suggested that the standard of education for nurses should be the B.S.N., beginning a debate that still exists today. From 1987 to 2003 North Dakota was the only state to require a bachelor's degree for nursing licensure. This law was revoked in 2003, allowing nurses with diplomas or A.D.N. degrees to practice. In 2010 New York and New Jersey debated "B.S.N. in 10" legislation, which would require future nurses to obtain their B.S.N. degree within 10 years of licensure to continue practicing. This law would not affect already practicing nurses or those enrolled in nursing school before the legislation is passed. Nearly 20 other states have considered similar proposals.
Benefits of the Bachelor's Degree
B.S.N. students spend more time in the classroom, learning leadership and management skills, as well as receiving more instruction in preventative care and medical law. A bachelor's degree can also translate into greater career opportunities, as many hospitals prefer to hire nurses with higher degrees. In addition, nurses who want to qualify for work as a nurse anesthetist, nurse midwife, clinical nurse specialist or nurse practitioner must hold a bachelor's and a master's degree.
It is highly unlikely that most states will pass legislation requiring a bachelor's degree in nursing for licensure, as such a requirement would virtually eliminate diploma programs at hospitals and A.D.N. programs at community colleges. Because there is currently a shortage of nurses in the United States, eliminating licensure programs is not a good option. Some institutions and states, however, are considering requiring registered nurses who do not hold a B.S.N. to return to school to obtain the degree. As a result, many four-year universities have created accelerated R.N.-to-B.S.N. programs to better serve working nurses who wish to earn a higher degree.