If you’re interested in a career as a registered nurse (RN), there are several paths for starting your career. To become a nurse you can earn a 2-3 year RN diploma or associate degree in nursing (ADN) or a four-year bachelor of science in nursing (BSN). This page covers educational requirements and career options so you can better decide which educational pathway is right for you.
To explain the different routes to becoming a nurse, Nursejournal made this helpful video.
Earning your RN through a diploma or associate degree program is usually a one- or two-year process, while getting your BSN straight out of high school will take four years. The advantage of becoming a RN through a diploma program is that it does not take as much time as a BSN. Once you pass your NCLEX exam, you can start working and gaining experience as a nurse right away.
Many nurses choose not to earn their BSNs right out of high school; however, nurses who start out with an ADN or diploma often decide to earn a BSN later in their careers. The good news is that if you have an RN diploma or associate degree, your credits will usually transfer and you can earn a BSN in as little as two years. These days, there are many RN-to-BSN degree programs available, many of which are online.
What to Expect From a Nursing Diploma Program
Though curricula 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
- Psychology: Studying how the mind works and why people behave the way they do can help nurses understand and care for their patients. Psychology helps nurses relate to patients and create a positive environment for recovery.
- Biology: Human beings are living organisms, so understanding human development and anatomy can help nurses better perform their jobs. Biology is the foundation for modern medical knowledge, and nurses can apply biology basics to everyday interactions with patients in a medical setting.
- Basic Pharmacology: Nurses work around patients who might be on different medications, and knowing about different medications is important for ensuring patient safety. Studying medication dosage, side effects, and interactions helps nurses do their jobs safely and responsibly.
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 has its own requirements and prerequisites, and course length can change depending on full- or part-time enrollment. Class availability and program style can also play a roll. Some programs will allow transfer credits, or students can 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
An internship is a great way to gain practical experience in nursing before you officially join the field. It is also an opportunity to connect with experienced nurses and network with other students.
On average, you can expect an internship to take 5-10 hours per week — sometimes more — and to take place in a hospital, clinic, and or other medical setting. Your internship experiences help you focus your studies and apply your education in a practical setting.
What to Expect From an ADN Program
An associate degree in nursing is the minimum requirement necessary for obtaining an RN certification. Below are a few ADN program sample courses.
Sample Courses for an ADN Program
- Nursing Fundamentals: Fundamentals is probably the most important class in a nursing program. It explores different aspects of nursing jobs, including daily duties and routines, responsibilities, and how to set short- and long-term goals for patients. This class is the foundation upon which the rest of the program is built.
- Pediatrics: This course covers the responsibilities of a pediatric nurse and issues specific to child care. You will learn about common pediatric care techniques, the general needs of children, and common medical complaints in child patients.
- Behavioral Health: As a nurse, you will interact with people from all walks of life, whether they are a patient, a family member, or part of the medical staff, and you must be able to recognize and respond to behavioral issues when they arise. This class will teach you the basics of behavioral health.
How Long Does It Take to Complete an ADN Program?
A typical ADN requires 60 credits, depending on what school you attend. In some cases, an internship is included in your required courses, which can make your credit load a little higher. In other cases, science courses with a lab component can include extra credits. Most ADN programs take 2-3 years to complete.
Clinical Component for ADN Students
Many healthcare clinics offer internships to ADN students. An internship helps students get practical training in clinical labs shadowing tenured nurses. Internships usually take place in hospital or clinics, but can be at 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 on candidate resumes. A clinical internship helps you know what to expect once you become an official nurse.
What to Expect From a BSN Program
A BSN degree program is extremely rewarding for anyone who chooses to become a nurse. There are a variety of available specializations for nurses.
Concentrations Offered for a BSN Program
Family Nurse Practitioner
Under the supervision of a doctor, family nurse practitioners typically examine patients, diagnose illnesses, and prescribe medications. When patients get their yearly check-ups, the FNP usually does 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 over a long period of time.
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 research and data from various different medical settings and analyzes it, seeking improvements to nurse 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, ensuring that patient needs are being met. A nurse advocate improves hospital communication and helps protect patients from unnecessary stress.
Sample Courses for a BSN Program
- Human Anatomy: Understanding the human body is essential for nurses, who come across patients with different needs, body types, injuries, and illnesses and must be able to work with all of them. Knowing how the body is supposed to work helps nurses properly address patient needs. This class can help you learn about different body parts, muscle and tissue groups, and other bodily systems.
- Principles of Ethics: Understanding ethics is key when it comes to responsible nursing. Nurses must be able to treat patients while also protecting their privacy and adhering to HIPAA regulations. Nurses must also comprehend the legal consequences of patient mistreatment, which are covered in this course.
- Pathophysiology: Nurses come into contact with many different sicknesses, ailments, and diseases. This class helps nurses understand the causes of diseases and how to help the body heal.
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 have an ADN already, it will probably transfer to your bachelor’s degree where it accounts for 60 credits, and you can expect to graduate in 2-3 years. You might also consider a special RN-to-BSN program, which can shorten program duration.
If you don’t have an associate already, expect a BSN to take you 3-5 years. Other time-sensitive factors include internship, class availability, and course style. A full-time student will graduate much sooner than a part-time student; there are also accelerated BSN programs.
Clinical Component for BSN Students
BSN internships allow you to apply your knowledge in a nursing setting. When you intern, you can shadow nurses who have years of experience and can mentor you as you transition into your nursing career. 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 in these internships.
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Source: BurningGlass.com (analysis of nurse job postings, 4/25/2013-7/21/2013)
Different Job Types
Whether you earn a BSN, ADN, or diploma in nursing, you will be involved in direct patient care; however, the type of work you do will depend upon your education level.
People with an RN designation do 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.
If you earn your BSN, you will have many more options, 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 is required to even be considered for a nurse educator position.
A BSN is also 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), holding a BSN first makes this process easier.
An addictions nurse provides treatment for patients suffering from drug or alcohol addition. To be an addictions nurse, you have to at least earn your ADN.
Cardiovascular nurses specialize in cardiovascular disorders like heart disease, working under the direction of a cardiologist. These nurses need an ADN at minimum, but a BSN is preferred.
Critical Care Nurse
Critical care nurses work in emergency rooms and other crisis settings, caring 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 genetic disorders and diseases and patients who either suffer from them or are likely to develop them. A BSN is required to pursue this profession.
Nurse who work with newborn or premature infants in the first few weeks or months of their lives are called neonatal nurses. You may enter this profession with an ADN, but most employers require a BSN.
A nephrology nurse works with patients with kidney disorders, and their duties include administering dialysis. To enter this profession, you need a BSN and experience working in a nephrology setting.
Public Health Nurse
Public health nurses are responsible for educating the community about health issues, covering things like flu shots, sex education, and preventative care tips. You need a BSN and have to pass the NCLEX exam to become a public health nurse.
As the name implies, a rehabilitation nurse works with patients suffering temporary, progressive, or permanent illnesses or disabilities and helps them navigate daily activities. An ADN or BSN is required to become this type of nurse.
Salary Potential for ADN and BSN Graduates
The field of nursing is booming, with the Bureau of Labor Statistics (BLS) projecting that the number of registered nursing jobs will grow by 15% from 2016 to 2026, much faster than average. According to the BLS, there were 2,955,200 licensed RNs in the US in 2016 and another 438,100 are projected to join the workforce by 2026. The Bureau also reports that the national median salary for RNs at all degree levels was $70,000 as of 2019.
According to the Health Resources and Services Administration, 55% of working RNs hold a bachelor’s degree or higher. To stay competitive in the field of nursing, it is increasingly important to earn at least a BSN.
Along with better job opportunities, a BSN can also increase pay. PayScale shows the additional earning power that comes with earning a BSN when compared to RNs with an ADN. When entering the field, ADN-holders report making around $57,000, while entry-level nurses with a BSN report making over $70,000. The differences between an ADN RN vs BSN salary are illustrated in the chart below.
|Experience||Median Salary for RNs with an ADN||Median Salary for RNs With a BSN|
|Less than 1 Year||$57,088||$70,532|
When looking at salary data for BSNs based on job type and level, the potential for higher earning power becomes more clear, with BSN clinical nurse managers reporting a median annual salary of nearly $84,000 and nursing directors making over $90,000.
|Position||Median Salary for RNs With a BSN|
|Family Nurse Practitioner (NP)||$93,864|
|Nurse Case Manager||$70,460|
|Clinical Nurse Manager||$83,652|
Evidence Shows That Nurses With a BSN Give Better Care
For the last 10 years, the American Association of Colleges of Nursing (AACN) has conducted research that shows that higher education makes a difference in the quality of clinical practice. Studies show that patients in the care of nurses with a BSN have better outcomes, including lower rates of mortality.
Also, research shows that nurses who have a BSN 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 2020
When determining which education pathway to take, either an ADN or a BSN, consider which one will better prepare you to be an RN. The Health and Medicine Division (HMD) projects that the number of nurses with a BSN will increase from 50% to 80% by 2020 and employers have shown an increasing preference for BSN candidates. In 2011, only 30% of employers required a BSN, compared to 45% in 2014, and 79% strongly preferring a BSN.
According to the AACN, many hospitals and other medical facilities are strongly encouraging ADN-prepared RNs to earn their BSN within five years of graduation.
Earning your RN diploma or ADN is a great start to your nursing career. You can graduate quickly, which allows you to start earning money and gaining nursing experience right away. That way, you can try out the career and narrow down your specialization preferences before you commit to a BSN program.
However, when you look at RN vs BSN career and salary options, you will be limited with only an RN diploma or ADN. To meet future health management requirements, recent research and public policy recommendations strongly stress the need for more highly educated nurses. Industry trends are definitely moving toward a BSN as the standard pre-licensure degree, and in coming years it may very well be required.