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Introduction   

Today, many employers require that their registered nurse employees hold a Bachelor of Science in nursing degree. This course will explain the rationale behind this requirement, as well as practical ways a registered nurse or licensed practical/vocational nurse might successfully complete a bachelor’s in nursing program while working. Other tips include financing, finding a work-life-school balance, and career advancement opportunities.  

Why Get a Bachelor of Science Degree in Nursing?  

For those just getting their registered nurse (RN) licensure, the term Bachelor of Science in Nursing (BSN) is likely a hot-button topic, particularly if the RN has graduated from an associate degree program. For those who do not plan on enrolling in an RN to BSN program, the question becomes, “Why even get a bachelor’s degree when I already have my RN license.” The simple answer is that more and more hospitals require a BSN for employment and there are many more job opportunities available if you obtain this degree. There are also patient benefits to holding a BSN. 

Call to Action 

In 2011, the Institute of Medicine (IOM), currently the National Academy of Medicine, published a landmark report called The Future of Nursing: Leading Change, Advancing Health. The IOM included a call to action for 80% of RNs to have their BSN by the year 2020; in 2011, approximately 50% did, and as of April 2023, nearly 72% have met this goal (1, 2, 3). The IOM explained that due to an increasingly complex patient population, nurses need to be prepared to effectively lead within the healthcare industry with greater autonomy and critical thinking skills (1, 2).  

Better Patient Outcomes 

The IOM report and a large number of studies have now linked BSN-prepared RNs with better patient outcomes, especially reduced mortality rates (1, 3, 4, 5). One study in 2022 noted that in hospitals with higher proportions of BSN nurses, there are significantly lower odds of mortality after 30 days of inpatient surgery (4). Another 2019 study noted that hospitals having higher levels of BSN-prepared nurses is directly related to shorter inpatient hospital stays and lower rates of readmissions (5).  

Other patient statistics in favor of BSN nurses are (6): 

• Patients have a 24% greater chance of surviving an in-hospital cardiac arrest 

• Significantly decreased overall patient mortality 

• Patients with Alzheimer’s disease and related dementias (ADRD) have 10% lower odds of death 

Better Pay and Professional Opportunities 

With higher levels of education, nurses can generally enjoy a higher salary and more job options within and outside of the healthcare field. By one measure, the national yearly average for an RN with an associate degree of nursing (ADN) is approximately $77,000 as of June 2024, whereas a BSN-prepared RN makes an average of about $94,000 (10). The landmark IOM report has a table demonstrating that BSN nurses make about 10% more annually than their ADN counterparts (10).  

Advancing your degree by attending an RN to BSN program may create more job opportunities as well. For example, a BSN nurse is often required or preferred for the following specialties or roles (7, 8): 

• Case management 
• Clinical trials 
• Hospice 
• Nursing administration 
• Nursing education 
• Nursing informatics 
• Nursing management 
• Operating room 
• Palliative care 
• Pharmaceuticals 
• Public health 
• Research 
• Teaching as adjunct or associate professor 

Position Statement 

In 2013, the American Nurses’ Association (ANA) endorsed the 2011 IOM report calling for a higher number of BSN nurses in the U.S. (9). The ANA states that their position stems from evidence-based strategies and argues that all nurses should have access to “seamless academic progression through high-quality, accredited nursing education programs that will meet the anticipated demand for qualified nurses over the next several decades” (9).  

Advantages Attending School While Working as an RN, LPN, or LVN 

While not everyone agrees with the IOM and ANA’s positions on the importance of obtaining a BSN, there are many advantages to doing so while working as a nurse. Among these are tuition reimbursement, making nurse wages while going to school, online coursework, and pay increase after graduation. 

Tuition Reimbursement 

Many hospitals and other organizations offer significant reimbursement for BSN and other healthcare-related courses. Keep in mind that employment usually needs to be part- or full-time for this benefit, and the employer may require a work commitment after the tuition has been paid. 

Making Nurse Wages While Completing a Degree 

Attending an RN to BSN program while working as a nurse has its benefits. Nurses make a respectable income, with or without a BSN. As discussed above, BSNs make more money, but ADNs also average around $77,00 per year annually. 

Online Coursework 

Nearly all RN to BSN (and LPN/LVN to BSN) programs in the U.S. have options for online classes. While some in-person clinical hours may still be required, the bulk of the degree can be done in an asynchronous setting, meaning nurses can work towards the BSN in their free time.  

Pay Increase Upon Completion 

When the nurse completes the RN to BSN program and obtains a BSN, the employer will likely award an immediate pay raise, even if they also provided tuition assistance. Future raises will also be larger in turn, given the higher base salary the BSN-prepared nurse now has.  

Tips for Managing Work, School, Home Life, and Finances 

Getting another degree can be a daunting, time-consuming task, especially if work and family obligations are a big part of one’s life. Fortunately, many RN to BSN programs are only one year in duration, if completed full-time. Here are some tips for managing work-life balance while attending school. 

Shop Around 

Not all BSN programs are the same. Some are far more cost-effective than others, with the cheapest generally being public universities. At the time of this writing, there are about 750 RN to BSN programs offered in the U.S. (3). Keep in mind that your employer will only give you a set amount of tuition reimbursement each year, so a less expensive program or lighter courseload might suit your needs better than a smaller, for-profit school.  

Work with an Advisor 

Working with an advisor may be beneficial. A good program advisor will make sure you petition to graduate on time and stay on track with your coursework.  

Know Yourself 

Knowing yourself is important. You must decide if you want the momentum from nursing school to keep going or need a year or two off to focus on your job. Keep in mind many employers require the BSN to be completed within two to five years of hire. 

Apply for Scholarships 

Many nursing organizations offer scholarships. This includes the American Nurses’ Association and their state affiliates, as well as National Nurses United. Whatever your specialty (oncology, emergency, pediatric, etc.), join the associated professional organization and apply for their scholarship. The benefit to scholarships awarded by organizations over employer’s tuition reimbursement program is that scholarships don’t have to be paid back either in time or money.  

Consider Student Loan Forgiveness 

Student loan forgiveness programs can relieve debt while you attend school. For nurses, there is a program called Public Service Loan Forgiveness (PSLF), which can be accessed here: https://studentaid.gov/manage-loans/forgiveness-cancellation/public-service   

Schedule Work Shifts Carefully 

As many inpatient nurses work three 12-hour shifts, this frees up four days a week! However, those long hours can be exhausting, so rest time should be factored in as well. If you want, you can take just one or two courses at a time to make the coursework more manageable.   

Keep a Planner 

Using a planner to keep track of all assignment due dates and personal obligations may be helpful. For online courses, small assignments like discussion board posts and responses can creep up quickly! It’s best to integrate work, school, and personal calendars all in one spot, whether it’s electronic or on paper.  

Know Your Support Systems 

Can someone help with your household and family responsibilities while you’re working on classwork? Can you hire a caregiver for your children or parents, so that you can get necessary assignments completed? What other resources do you have that can help you succeed?  

Ask Other Nurses How They Did It 

You won’t be the only nurse who had to get a BSN after starting a job. Ask around for advice and tips. Maybe you’ll find someone who attended the same RN to BSN program you are considering, and they might give you their books and notes!  

Conclusion

No matter the reason for pursuing a BSN after obtaining RN or LPN/LVN licensure, there are many benefits to this process. Patients have been proven to have better outcomes in facilities who have BSN-prepared nurses, and the nurses themselves end up with more autonomy in the workplace. Fortunately, we live in a time where online RN to BSN programs are prolific, with many funding opportunities available. With proper planning and resources, the BSN could end up being a free endeavor that leads to increased wages and more desirable nursing positions.  

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