Students interested in becoming registered nurses (RNs) can pursue several paths to start their careers. To become a nurse, you can earn a 2-3 year RN diploma, associate degree in nursing (ADN), or a four-year bachelor of science in nursing (BSN). This page covers educational requirements and career options to help identify your ideal educational pathway.
In This Article
- Education Requirements
- What to Expect From a Nursing Diploma Program
- Frequently Asked RN vs. BSN Questions
- Interview with a Registered Nurse
- What to Expect From an ADN Program
- What to Expect From a BSN Program
- Different Job Types
- Salary Potential for ADN and BSN Graduates
- Evidence Shows That Nurses With BSNs Give Better Care
- Another Good Reason to Earn Your BSN
To explain the different routes to becoming an RN vs. a BSN, NurseJournal.org made this helpful video.
Becoming an RN through a diploma program allows nurses to enter the workforce more quickly than by earning a BSN. Once you pass the NCLEX, you can start working and gaining experience as a nurse right away.
Many nurses choose not to earn their BSNs after high school. Nurses who start with ADNs or diplomas often decide to pursue BSNs later in their careers. If you have an RN license or associate degree, your credits will usually transfer, allowing you to earn a BSN in as little as two years. Nurses can also pursue online RN-to-BSN degree programs.
What to Expect From a Nursing Diploma Program
Though classes vary by program, any accredited diploma program will prepare you for a career as a licensed nurse. Below, you'll find some example courses from diploma programs.
Sample Courses for a Nursing Diploma Program
How Long Does It Take to Complete a Nursing Diploma Program?
The length of time it takes to complete a nursing diploma program varies based on several factors. Each school maintains distinct requirements and prerequisites, and course length can change depending on full- or part-time enrollment. Class availability and delivery method can also play a role. Some programs will allow transfer credits. Degree-seekers can also take aptitude tests to receive credit and waive certain courses.
On average, it takes a student 2-3 years to complete a nursing diploma program, but actual time varies by individual.
Clinical Component for Nursing Diploma Students
Internships provide practical experience in nursing before officially joining the field. These experiences also allow you to connect with experienced nurses and network with other students.
On average, you can expect an internship to take 5-10 hours per week and take place in a hospital, clinic, and or other medical settings. Your internship experiences help you focus your studies and apply your education in a practical setting.
Frequently Asked RN vs. BSN Questions
- What is an RN to BSN program?
An RN-to-BSN program provides a bridge between an associate degree or diploma and a bachelor's. These programs offer current RNs a direct pathway to earning their BSNs, often in two years or less. RN-to-BSN programs allow students to take the necessary courses required to earn bachelor's degrees while completing clinical requirements as RNs.
- Why get a BSN?
Although most states require only an ADN to earn RN licensure, more states continue to push for the BSN to serve as the new required minimum degree. The AACN reports that patient care provided by BSNs tends to lead to lower mortality and readmission rates. Those with BSNs may also receive higher salaries.
- Can you get a BSN degree without an RN license?
Students may choose to enter a BSN program directly from high school or without earning an ADN. You can earn a BSN degree without a current RN license, as the BSN prepares graduates to sit for the NCLEX-RN and earn licensure. Some students may choose to earn an LPN license before earning their BSN.
- What comes after a BSN degree?
After earning a BSN, some students may choose to pursue graduate degrees in nursing, like a master's or doctorate. These degrees meet the requirements to become an advanced practice registered nurse (APRN). In many states, APRNs hold full practice authority, allowing them to function as primary care providers.
Interview with a Registered Nurse
Audrey Cortez has been an RN for over 20 years and completed her BSN in 2019. Audrey has worked in many different nursing specialties, including medical/surgical, long term care, home health, case management, and nursing management.
Her next goal is to become certified as a holistic nurse through the American Holistic Nursing Credentialing Corporation. She is the founder and owner of Holistic Wellness RN. Audrey is also a reiki master and reflexologist. She fully supports integrative healthcare for optimal health and wellness.
Why did you decide to pursue your BSN after working as an ADN?
My reasons for pursuing my BSN were twofold. First, it was to have a larger selection of career opportunities. Secondly, I wanted to complete my BSN for personal satisfaction.
In your opinion, should a BSN be required for RNs?
I think a BSN should be required for RNs. Research shows that facilities with a large number of BSN-prepared nurses have better patient outcomes and decreased patient mortality.
In which situations/roles might an ADN be sufficient?
Working in a doctor's office or clinic could be an appropriate setting for an ADN nurse to work.
What hard/soft skills do you gain in a BSN program that you might not gain in an ADN program?
An ADN program focuses mostly on clinical skills such as inserting urinary catheters. A BSN candidate also learns clinical skills in addition to nursing research, leadership, and management.
Do you find that more nurses being hired today hold BSN degrees?
Yes, more employers require RNs to have a BSN degree. In 2010, The Institute of Medicine recommended that 80% of RNs should earn a BSN by 2020, due to the growing complexity of nursing. Also, hospitals working towards magnet status must show proof that 80% of their RNs have BSNs.
What about program curriculum -- how much more rigorous is a BSN program?
Compared to my ADN program, my BSN program required a lot of papers. If you do not enjoy writing, you may struggle with this aspect of BSN programs. Also, several of my BSN courses involved conducting evidence-based research. Conducting research alone can be rigorous -- having to then write a paper about it makes the project even more rigorous.
What advice would you give prospective nurses considering between an RN and BSN degree?
It really depends on their career goals. Nurses can first complete their ADN and secure employment with a company that offers tuition reimbursement. They can then complete their BSN with their employer's help. If they aspire to work in a hospital, then they should complete their BSN from the start since many hospitals require a BSN upon hire.
What to Expect From an ADN Program
An ADN is the minimum requirement necessary for obtaining an RN certification. Read on for a list of common ADN courses below.
Sample Courses for an ADN Program
How Long Does It Take to Complete an ADN Program?
A typical ADN requires 60 credits, which sometimes includes an internship, depending on the school. In some cases, science courses with a lab component can include extra credits. Most ADN programs take two years to complete.
Clinical Component for ADN Students
Many healthcare clinics offer internships to ADN students. An internship helps students receive practical training in clinical labs by shadowing tenured nurses. Internships usually take place in hospitals or clinics, but they also occur in schools. Time commitment varies from 5-15 hours per week, and internships may be paid or unpaid. Students often receive college credit for internships, and potential employers look for this kind of experience from applicants. A clinical internship helps you know what to expect once you become an official nurse.
What to Expect From a BSN Program
BSN programs, which typically take four years, offer more advanced courses than in ADNs. Enrollees can pursue many different specializations, and professionals who earn bachelor's degrees typically receive higher pay.
Concentrations Offered for a BSN Program
Family Nurse Practitioner
Under the supervision of a doctor, FNPs typically examine patients, diagnose illnesses, and prescribe medications. When patients get their yearly check-ups, the FNP usually performs most of the exam, with the doctor only stepping in for the final consultation.
Diabetic patients have specific needs, which diabetes nurses are specially qualified to meet. They work directly with diabetic patients to manage medications and ensure regular check-ups. These nurses usually have a close relationship with their patients since they work together for long periods.
Nurses don't just perform physical duties to care for patients. They also do behind the scenes work, like collecting medical data and conducting research. An informatics nurse gathers data from different medical settings and analyzes it, seeking improvements to nursing practices.
These nurses work primarily in hospital settings where they assist in surgeries and prescribe and prepare medications for patients. Many medical-surgical nurses work in emergency settings, so the job requires a level head.
Nurse advocates serve as a conduit between hospital staff and patients to ensure that patients receive top-level care. A nurse advocate improves hospital communication and helps protect patients from unnecessary stress.
Sample Courses for a BSN Program
How Long Does It Take to Complete a BSN Program?
The time it takes to earn your BSN degree depends on a few factors. As a general rule, bachelor's degrees require 120 credits. If you already possess an ADN, it will likely transfer to your bachelor's degree, leading to graduation in 2-3 years. RN-to-BSN programs can shorten program duration, as well.
With an ADN, you can expect a BSN to take less than four years. Other time-sensitive factors include internships, class availability, and delivery method. A full-time student will graduate much sooner than a part-time student. Accelerated BSN programs also allow enrollees to graduate in less time.
Clinical Component for BSN Students
BSN internships allow you to apply your knowledge in nursing settings. When you intern, you can shadow nurses with years of experience and the wisdom that comes with it. Internship hours vary by specialization, setting, and school requirements, but the average internship takes 5-20 hours per week, and most students receive class credit for participating.
Different Job Types
Whether you earn a BSN, ADN, or diploma in nursing, you will spend time in direct patient care. The specific type of work, however, will depend on your education level. An individual with an RN designation performs simple nursing care, such as recording patient symptoms, working with simple medical equipment, educating patients on diseases and illnesses, and consulting with doctors and other nurses.
Nurses who earn BSNs can pursue more professional roles, some of which come with more responsibility and higher pay. People with a BSN can choose to be a nurse educator, a public health nurse, or to specialize in specific age groups or disease types. A BSN also acts as a stepping stone to more advanced nursing roles, including nurse practitioner, nurse midwife, or clinical nurse leader. All of these jobs require you to earn your master of science in nursing (MSN).
An addictions nurse provides treatment for patients with drug or alcohol addiction. These nurses must earn at least an ADN.
Cardiovascular nurses specialize in disorders like heart disease, working under the direction of a cardiologist. These nurses need an ADN at minimum, but most employers prefer BSNs.
Critical Care Nurse
Critical care nurses work in emergency rooms and other crisis settings to care for medically unstable patients. Depending on where you want to work, a nursing diploma, ADN, or BSN can qualify you for this position.
A genetics nurse focuses on gene-related disorders and diseases, along with patients who either suffer from them or become likely to develop them. These professionals must possess BSNs.
These nurses work with newborns and premature infants in the first few weeks or months of their lives. You may enter this profession with an ADN, but most employers require a BSN.
A nephrology nurse works with patients with kidney disorders, often administering dialysis. To enter this profession, you need a BSN and experience working in a nephrology setting.
Public Health Nurse
Public health nurses educate the community about health issues, including flu shots, sex education, and preventative care tips. You need a BSN and have to pass the NCLEX to become a public health nurse.
A rehabilitation nurse works with patients suffering temporary, progressive, or permanent illnesses or disabilities, helping them to navigate daily activities. These nurses must possess ADNs or BSNs.
Salary Potential for ADN and BSN Graduates
The Bureau of Labor Statistics projects a job growth rate for RNs (12%) that far exceeds the rate for all professions from 2018-2028. The median pay for RNs reached $71,961 in 2018, but pay varies based on factors such as location, employer, experience, and education. Those with ADNs tend to earn significantly less than nurses who hold BSNs. The extra education and training yield more salary growth potential and job opportunities, as healthcare employers often seek out BSNs.
An RN with a BSN may take on more roles, including case management, clinical nurse management, and nursing director. Nurse case managers earn a median pay of $71,743, while clinical nurse managers earn a median of $82,215, and nursing directors earn a median of $88,997. Comparatively, nurses with ADNs tend to earn a median pay of $69,000, according to PayScale.
|Family Nurse Practitioner||$113,930|
|Nurse Case Manager||$71,961|
|Clinical Nurse Manager||$82,312|
Evidence Shows That Nurses With BSNs Give Better Care
For the last 10 years, the American Association of Colleges of Nursing (AACN) has conducted research indicating that higher education makes a significant difference in the quality of clinical practice. Studies show that patients in the care of nurses with BSNs have better outcomes, including lower rates of mortality. Research also indicates that nurses with BSNs are more proficient in making diagnoses and evaluating the results of interventions.
Another Good Reason to Earn Your BSN -- It May Be a Requirement
In 2017, New York passed a law requiring all licensed nurses to hold or obtain a BSN within ten years of earning initial nursing licensure. RNs who held licensure before the enactment of this law remain exempt from this requirement, along with students enrolled in ADN programs at the time of enactment.
Many have pushed for raising the minimum education requirement for RNs for decades, with the American Nurses Association first advocating for this change more than 50 years ago. Although this law pertains specifically to New York, other states may follow their lead in enacting a higher minimum education for RNs. Research has shown that care provided by BSNs tends to lead to lower mortality and hospital readmission rates.
Additionally, the AACN has considered raising the minimum education requirement, citing the research regarding higher standards and quality of care provided by BSN graduates. The federal government, along with the military and other nursing organizations, also advocate for requiring a BSN for nursing practice. Earning a BSN now may provide students with the best education in the long-term, particularly if more states begin requiring a bachelor's degree to earn RN licensure.