By Medora McGinnis. Medora is a student at Bon Secours Memorial College of Nursing in Richmond, Virginia, and the 2011-2012 Imprint Editor of the National Student Nurses’ Association (NSNA). This is her first post for this blog. 

There was a time when the majority of all nursing programs were diploma programs, emphasizing practice over theory. They were largely based out of hospitals and proved very well suited for this training. Popular among students, they provided the majority of the nursing workforce well into the 1950s. But these programs began to lose popularity as they were supplanted by other forms of training. At the same time, patient care was shifting and hospital care costs were exploding. By the late 1970s, 40 diploma programs were closing their doors every year.

The year is now 2011, and there are less than 40 diploma programs nationwide. I am a senior nursing student in one of these programs, and have been a part of their transition from the diploma to the four-year BSN. My graduating class will be the last of the diploma graduates, and many of us plan to continue our education and quickly complete an RN-to-BSN program. Why? Certainly to maintain our momentum, and to be competitive in today’s workforce. But the undertone in the nursing community, especially among young and new nurses, is that the BSN is required in order to earn respect.

One very interesting fact regarding diploma programs—one that most  people may not realize—is that there is typically only a 10-credit deficit between the diploma or ADN nurse and the BSN nurse. That’s correct, only 10 credits—or, for example, an average of three humanities courses. Many of these programs also have twice the number of clinical hours as BSN programs, preparing their graduates to walk right into the NCLEX exam (and pass with flying colors), and from there right into the nursing workforce.

But why am I making this point, when clearly there are only a handful of such programs left? Aren’t we talking about a dinosaur here? While many working RNs are graduates of diploma programs—and effective nurses, I might add—we are being encouraged to earn the BSN degree just to get hired in many hospitals, or so that a hospital where we already work can achieve Magnet status. And it’s not just new grads feeling the pressure, but also experienced, seasoned nurses.

However, there’s a practical problem here for many. How can a working RN, especially one with a complex life that often includes a family and other responsibilities, find a way to attend college to complete the RN-to-BSN program? Or how does a BSN nurse find a way to attend a master’s program or beyond? One way is through online RN-to-BSN programs and other “nontraditional” bridge programs that are often only two to three semesters long, partially or totally online, and provide the additional theory and research courses that diploma and ADN programs forgo so that they can offer the additional clinical time.

So again we face the issue of respect: such programs, while more appropriate for a busy, working, multitasking RN, may not earn the same level of academic respect as face-to-face RN-to-BSN programs. Some sources even go so far as to imply that any RN-to-BSN degree is inferior to a “traditional” four-year program. Maybe a little realism is called for. In the world we live in today, “traditional” is less and less visible. And do we all know exactly what we want to study when we’re 18? Or do some of us change careers, find a new calling, or choose a new challenge?

In reality, the initials after my name are what I’m after. I would like to feel proud of my academic accomplishment, and I know that I will—regardless of the institution listed on my BSN degree. As a wife, mom of five, successful full-time nursing student, NSNA editor, and hospital employee, I know that every single accomplishment in our lives should be celebrated. Like the note in our ICU staff restroom, “Remember to be nice. We may never know another person’s battle.”

New grad nurses are entering nursing in a remarkable time—evidence shows that minimum education requirements are reflected in patient outcomes. We are already onboard with this, and can’t wait to move forward. Even so, I can only hope that our nation of nurses will rise up to meet me, along with the coming wave of other RN-to-BSN graduates, and share the respect that we already have for them; we are all shoulder to shoulder, providing safe and competent nursing care.

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