Running head: ADN VS BSN

Nursing education
Associate degree vs bachelor degree in nursing in Hawaii
Naomi Masuda
NURS 362
3/27/2016

I am interesting and want to learn about the trend about educational requirements and how to deal
with the future nurse shortage which is expected to become increasingly crucial as the baby boomer
generation nurses retires. Associate degree programs were created in the 1950s and 1960s to deal with the

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nursing shortage in the US, and according to a 2010 study by the Department of Health & Human
Services, 66 percent nurses are at the associate degree level. Today, many hospitals are selecting nurses
with BSN degrees only especially since recent studies have indicated that there is decreased morbidity,
mortality, and failure-to-rescue rates in hospitals that employ larger percentages of baccalaureate prepared
nurses (Altmann, 2011). Also, the Institute of Medicine is recommending increasing the proportion of
nurses with BSNs from 50 to 80% by 2020 (Altmann, 2011). Because of this trend, many working
registered nurses are returning to school to upgrade their associate degree into a bachelor degree. In
Hawaii, about 70% students who completed nursing courses had bachelor degrees. On the other hand,
associate degree nursing students comprised about 14.8% of students in 2010, according to a career index
website. To meet the demand, our KCC program has an educational pathway to go to the fourth year of
the Bachelor of Science in Nursing program at UH Manoa and UH Hilo.
Management-level nursing positions usually require BSN or higher level of education. In a
medical setting where I have had my clinical rotation, daily tasks dont seem to be very different between
BSN and ADN nurses. I believe that once we are in the field, job performance and competency is more
important than the formal educational background. We need to adjust quickly and constantly to changes in
our practice. The nursing program teaches us the basics, however, we need to implement our care safely
and effectively, while being patient-centered, efficient, and equitable. Ongoing self-improvement and
study is crucial to meet the changes.
Even working registered nurses want to go back to school to get a bachelor degree, however there
are many barriers such as time and financial demands of the classes as well as geographical problems
such as living too far from required classroom and clinical locations to reasonably commute. One of the
studies I read identified that each year in school reduces ones expected lifetime earnings by about
$40,000. If the nurses are already working full-time, they might need to reduce their working hours and
that leads to them losing their seniority. To enhance the numbers of working registered nurses going back
to school for BSNs, employers should support and encourage them in advancing their education. It took

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me about five years to decide to go back to school to advance from LPN to RN, because I had to consider
many issues and prepare for them with my family.
Hawaii is a geographically isolated area with limited employment opportunities for many
vocations, including nursing. Many RNs who recently graduated are not working as RNs, because of this
tight job environment. Most nursing jobs are concentrated on Oahu. According to career index website,
12,390 of Hawaiis 16,690 nursing professionals work in Honolulu. For neighbor island RNs, the job
market is tighter and employment in their desired field may require relocation to Honolulu. Some move
out to another states for better job opportunities.

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References
Altmann, T. K. (2011). Registered nurses returning to school for a bachelors degree in nursing:
Issues emerging from a meta-analysis of the research. Contemporary Nurse: A Journal For The
Australian Nursing Profession, 39(2), 256-272 17p.
4 Accredited Nursing Schools in Honolulu, Hawaii. (n.d.). Retrieved March 28, 2016, from
http://www.educationnews.org/career-index/nursing-schools-in-honolulu-hi/