Registered nurses — including those with an associate degree in nursing — can pursue a wide range of specialties. However, some nursing jobs require more than an ADN. Earning a Bachelor of Science in Nursing through an RN to BSN program can open doors to more employment opportunities.
Why do some positions require a BSN when both degrees require NCLEX certification and RN licensure? First, as of 2010, 55 percent of RNs have earned at least a bachelor’s degree, which increases the competition for nursing jobs.
Second, the Robert Wood Johnson Foundation (RWJF) and the Institute of Medicine (now known as the National Academy of Medicine as of 2015) completed a two-year initiative assessing the nursing profession. The goal was to determine how to transform the profession to prepare for more complex healthcare needs. The result is a landmark report titled The Future of Nursing: Leading Change, Advancing Health. One of its key recommendations is to increase the number of nurses with a BSN to 80 percent by 2020.
The Need for More Nursing Education
Driving the need for more education is the expectation that one-third of the nursing workforce will retire within 10 years, so the industry will lose many experienced and knowledgeable nurses. On top of that, 70 million baby boomers will enter their senior years. Many will need professional care to address chronic and degenerative medical conditions. Further, because there will likely be a physician shortage, the healthcare industry will rely more on nurses.
How are ADN and BSN degrees different? The latter requires two additional years of study. RN to BSN programs specifically accommodate RNs who already have experience in the field and want more training to earn the BSN. These programs cover new material without repeating information ADN nurses have already learned.
In The Impact of Education on Nursing Practice, the American Association of Colleges and Nursing references articles and reports that show how RNs with BSN degrees can positively affect patient care. The following are two examples:
1. A study published in the October 2014 issue of Medical Care reports that BSN nurses lowered the odds of patient mortality by almost 11 percent. It also reports that if 80 percent of nurses earn a BSN, it would “significantly lower readmission rates and shorten lengths of stay.” The cost savings from this will offset the cost of hiring nurses with BSNs.
2. The March 2013 issue of Health Affairs cites a study that asserts that, on average, an increase in the number of nurses earning BSN degrees by 10 percentage points will reduce deaths by 2.12 per 1,000 patients.
Jobs that Typically Require a BSN
Case managers work with patients who need long-term care. They coordinate discharge plans, accommodate Medicare or Medicaid requirements and work with insurance companies. Case managers may work in hospitals, rehabilitation clinics or as independent consultants.
With input from insurance companies, CMs determine how often they need to meet with a patient in order to maintain their care. Some enter a specialty like geriatric or pediatric care or treat people with specific disease such as cancer or HIV/AIDS.
The job may involve researching treatments, conditions and procedures. It requires 30 hours of continuing education classes in case management nursing. Salary.com indicates that the average annual salary for a case management nurse ranges from $67,000 to $80,500.
Clinical Research Nurse
Also known as a nurse researcher, a clinical research nurse collaborates with a medical study’s primary researcher to provide and coordinate care for research participants. The research nurse ensures that the clinical study follows protocol. This may include patient safety, data collection, recording accuracy, maintenance, and post-op follow up.
Before taking the clinical research coordinator certification exam, interested nurses must have a number of hours of documented experience in clinical research. There are different levels of clinical research nurses with requirements that depend on education and experience. ExploreHealthCareers.org reports the average salary of a research nurse at $95,000.
Critical Care Nurse
The American Association of Critical-Care Nurses identifies critical care nurses (CCNs) as licensed professional nurses who provide optimal care for critically ill patients. CCNs work in various settings where they may be educators, researchers, bedside clinicians, nurse managers and nurse practitioners.
Although it may be possible to work as a CCN with either an associate degree or a bachelor’s degree in nursing, each state’s Board of Nursing dictates its own requirements for the position. A critical care nurse certification is available, and some employers require it. The salary for a CCN ranges from $55,000 to $83,000, according to Nurse Journal.
Occupational Health Nurse
Occupational and environmental health nurses provide health and safety support to employees and community groups. They may observe workers in their job environments to assess potential hazards that may affect workers’ health or safety. OHNs offer advice on how to prevent injuries and health issues that may affect workers on the job.
The American Association of Occupational Health Nurses says OHNs may investigate occupational and non-occupational injuries and illnesses, conduct crisis intervention and counseling, assess employee workplaces for health hazards, manage cases relating to injuries and illnesses, and promote prevention strategies. Based on data from AAOHN, American Board for Occupational Health Nurses, Inc. says the average salary is $82k.
Oncology nurses treat cancer patients. Because they educate patients on the disease, treatment options and procedures, oncology nurses need continual education to stay on top of current treatments. Although some oncology nurses have an ADN, many employers prefer official certification in oncology nursing and a BSN.
Since oncology patients may have life-threatening diseases, oncology nurses must be emotionally stable. They help patients and their families cope with difficult diagnoses that could be fatal. Nurse Journal reports that oncology nurses earn anywhere from $58,000 to $81,000 per year.
Patient advocates are liaisons between physicians and patients. In this role, they ensure patients understand their diagnoses and treatment options. They may research healthcare legislation, insurance procedures and alternative treatment options. Advocates may also offer recommendations on the best courses of action.
This role is different from in-house advocates known as ombudsmen. In-house advocates’ first duty is to their facilities, not the patients. Patient advocates usually work for the patient â€” in some cases, they may work for a patient’s company. In Working In Retirement: How to Be A Patient Advocate, Kerry Hannon reports that patient advocates may earn anywhere from $20 to $250 per hour, with an average rate at $125 per hour.
Perioperative (Surgical) Nurse
Known as operating room or OR nurses, perioperative nurses work in day-surgery units, clinics, hospital surgical departments and physician offices. In general, OR nurses work with surgical patients and their families before, during and after surgery.
Their roles vary from scrub and circulating nurse to RN first assistant and nurse anesthetist. Each role has its own education requirements. The Association of periOperative Registered Nurses lists the base pay for perioperative nurses at $68,500 — salaries vary according to education, years of experience, job title and geographical region.
These nursing jobs all require RN licensure and NCLEX certification. Additional requirements can vary among facilities based on individual states’ Board of Nursing requirements.
Learn more about Colorado Mesa University online RN to BSN program.
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(n.d.). American Association of Critical-Care Nurses. American Association of Critical-Care Nurses Newsroom
(n.d.). What Is Occupational and Environmental Health Nursing? American Association of Occupational Health Nurses
(n.d.). Occupational Health Nursing Profession. American Board of Health Nurses, Inc.
(n.d.). Salary Survey and Calculator. AORN
(n.d.). Transforming Nursing Education. Campaign of Action
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Hannon, K. (2013). Working In Retirement: How To Be A Patient Advocate. Forbes
(2010). The Future of Nursing: Leading Change, Advancing Health. The National Academies Press
(n.d.). Critical Care Nurse Careers & Salary Outlook. Nurse Journal
(n.d.). Oncology Nursing Careers & Salary Outlook. Nurse Journal
(n.d.). What Is the Salary Outlook for Clinical Nurse Leader? Nurse Journal
(2016, September 30). Case Manager Salaries. Salary.com
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