--- title: 'The Meaning of a Degree' date: 2014-05-05 categories: - 'General Education' tags: - education --- The reasons why they may choose to do this are myriad. For some students, the BSN has long been a personal goal. For others, though, the decision isn’t internally motivated. Rather, they’re faced with either obtaining their BSN, or finding other employment. Now, for anyone outside of nursing, that latter reason might seem a bit harsh. But for those of us in the profession, it makes sense – at least to a degree. While I don’t disagree with the need for higher levels of education in nursing, I’m not so sure that the approach employers are using to encourage nurses to seek the BSN is the best approach. Let’s begin with a bit of background. ### Background Research has shown a correlation between the level of nursing education and positive outcomes. That is, where the percentagse of baccalaureate prepared nurses is relatively high, there are fewer complications, slightly fewer deaths per 1000, and other benefits to the organization and to the patient. In addition, the Robert Wood Johnson/IOM has generated several reports over the years that also document the benefits of higher levels of nursing education and have consequently called on nursing schools, and employers to increase the numbers of practicing BSN level nurses.  the RWJ/IOM report has recommended that 80% of nurses be prepared at the BSN level by 2020. On a more generic front, while all other healthcare disciplines have raised their educational requirements for entry to practice, nursing maintains the same educational requirements for entry to practice that have existed for more than 50 years. Times have changed, technologies have changed, knowledge has changed, and nursing needs to change in response. A third factor driving the push for nurses to get their BSN is something called “Magnet Status.” Magnet status is a designation made by the American Nurse Credentialing Center (ANCC) that recognizes hospitals for nursing excellence, quality patient care, and innovative nursing practices. Many organizations that either have achieved Magnet Status, or are working towards it, have established goals to increase the percentagse of BSN prepared nurses on staff. There are essentially three ways to achieve that goal: Hire only BSN nurses, encourage your current staff to go back to school, or decrease the number of non-BSN nurses on staff. The last two tend to work in concert and are often either transmitted, or interpreted, as “get your degree or lose you job.” Thus, many students are going back to school to keep their jobs, not because they are motivated. ### Just give me the degree I think that most educators would agree that external motivators, particularly negative motivators don’t lead to particularly good learning outcomes. And this is what I see. I can almost always immediately identify the student who comes to school “because I have to.” They are the ones who don’t want to do the work. They are the ones who complain about everything. They are the ones who become frustrated because they “don’t understand” what is expected of them because they are so busy just trying to rush through that they didn’t bother to read the syllabus – or the assigned materials. There is very much of a “Just give me the degree” mentality.  And that is, to me, very sad. One of the things that I try to communicate to students is that it isn’t just a piece of paper. That degree _means something_. When you tell someone you possess a degree, you are telling that you possess certain knowledge and skills that aren’t as easily found in those without the degree.  It’s not just about technical skills and knowledge. The BSN level nurse has a greater understanding of how things work together, how they interact. She is better prepared to see relationships, and to understand those relationships. She is better able to identify and anticipate the sequelae of patient situations. It is also about being able to read, understand, and implement the findings of nursing and medical research to benefit the patient and/or the organization – or themselves. It’s about being able to talk cogently with other medical professionals about patient situations to work collaboratively to improve outcomes. It’s about improving the position of nursing within the healthcare structure. It is, I think, indicative of the level of understanding that many ADN nurses see no difference between themselves and the BSN nurse. It is true that many BSN nurses, particularly straight out of school, work along side the ADN nurse, doing the same job. And, it is likely true that many don’t have the technical skills that the ADN nurse has on graduation. But what the ADN nurse doesn’t see is that the BSN nurse brings a different skillset to the table. The physical skills can be quickly and easily learned. What is more difficult to learn, and what the BSN prepared nurse generally does bring to the table, are the intellectual skills needed to see and anticipate problems before they occur, the awareness and understanding of research that impacts practice, and the importance of that research on patient outcomes. The ADN nurse, of course, can certainly develop those skills over time, but it is the orderly development of those skills through education that hastens the process for the baccalaureate nurse. ### What is the value of the degree? in the long run,  I believe that it is vital that we increase the number of BSN level (and higher) nurses. The value of the higher degree has been demonstrated through multiples studies. And, as nurses, we should be committed to doing anything that we can to improve the quality of care that we provide to benefit the patient. What is the value of the degree? To me it is the value of the we improved through our own improved knowledge and skill.