Bachelor of science in nursing (BSN)
In 1903, North Carolina was the first state to begin regulating the nursing profession. The new licensure introduced certain requirements, such as graduating from a nursing school, to work as nurse. By 1921, 48 states had enacted laws that regulated the nursing profession. In 1935, mandatory licensure for nurses became law, but wasn’t enforced until 1947 due to World War II. The title of registered nurse (RN) is now legally protected in all states and jurisdictions.
The work nurses do on a daily basis intersects with many vital issues of our day – from public health, aging, and diversity, to war, poverty, and the prison system. Nurses care for people at their most vulnerable – from NICU nurses tending to premature infants, to hospice nurses ensuring pain management and dignity at the end of life.
Nursing professionals are in high demand across the country, in community and acute care settings such as public health agencies, primary care clinics, nursing homes, outpatient clinics, schools, mental health agencies, hospices, and the military.
Nurses are the backbone of any hospital. In addition to being on the front lines of patient care, they offer education and counseling to patients and their families, supervise lower-level staff, and coordinate patient care with doctors and other healthcare professionals. They may also participate in policy deliberations, patient advocacy, and research.
There 4 main types of nurses are:
- licensed practical nurses (LPNs), also known as licensed vocational nurses (LVNs)
- registered nurses (RNs)
- advanced practice registered nurses (APRN)
- nurse practitioners (NP)
While an associate degree in nursing (ADN) is a great first step towards a nursing career, a BSN offers the widest range of possibilities after graduation. With a BSN, you can pursue a career as an RN, but also continue your education to become an advanced practice registered nurse, nurse practitioner, nurse educator, or nurse administrator.
Discover which universities in the country offer the best BSN programs.
In January 2020, the World Health Organization (WHO) decreed 2020 as the Year of the Nurse and the Midwife, in honor of Florence Nightingale’s 200th birthday. Interestingly, this happened on the brink of the COVID19 pandemic.
BSN program basics
Aspiring RNs usually undertake a BSN at some point in their career. While some states allow nurses to practice with an associate degree in nursing, career advancement may depend on earning a BSN. Additionally, 46% of employers require newly hired nurses to have a bachelor’s degree, while another 88% strongly prefer nurses with bachelor’s degrees. A higher salary, more available jobs, and better training in a specialized area are some of the main benefits of a BSN.
What can you do with a BSN?
The choice to pursue a BSN is usually a step towards a career as a registered nurse. In most states, passing the National Council Licensure Examination (NCLEX-RN) exam is required for becoming an RN. This is a standardized test run by the National Council of State Boards of Nursing (NCSBN). It has been designed to evaluate your ability to safely practice as a nurse.
If you hold a license in one state, you may be allowed to practice in another under the Nursing Licensure Compact. There are currently 39 states and jurisdictions that have enacted legislation allowing nurses to practice under the NLC.
Should you get a BSN?
If you’ve already made up your mind about becoming an RN, the BSN may be the best choice of degree in the long run. If you’re still debating whether or not a nursing career is for you, consider your strengths and interests. Most nursing jobs are centered on assisting and caring for others. Keeping thorough and accurate records and documentation are also crucial, as is communication with peers, supervisors, trainees, patients and their families.
The economic return on your investment in a degree is another important point to consider, as are employment prospects.
The below is a short-term comparison between the entire bachelor’s degree market and the BSN. It is a snapshot of earnings 2 years after graduation, detailing average earnings, the payback on your degree, and the employment rate with your degree.
The above table provides a snapshot of earnings 3 years after graduation. We compare the earnings of all bachelor degree recipients to those who graduated from this specific program.
The below is a longer-term estimate of degree performance. It is based on census survey data detailing people’s major, age, and salary.
Nursing is a lucrative career when comparing investment in education with eventual earnings. However, a desire to earn a lot of money is very rarely the motivation behind choosing a BSN degree. Instead, students usually choose this degree out of a passion for helping people and an interest in contributing to high-quality healthcare standards.
BSN holders have slower salary growth than average bachelor’s degree holders. This may be in part because significant career advancement in nursing – such as a move to an educative or management role – usually requires further education, such as a master of science in nursing (MSN) degree.
Nurses are less likely to see reduced wages in the final decade of their career. This may be the result of fewer nurses choosing early retirement, or the fact that nurses are not as likely as other professionals to take seniority cuts as they age.
Nurses walk an average of 4.5 miles per 12-hour shift. In comparison, the rest of the populations walks 2.5 miles total in a day.
How to pick a BSN program
If you are drawn to a particular field of nursing, a first step may be to look for programs that offer specialized training in that field. Nursing specializations include:
- obstetrics and gynecology
- community health
- neonatal intensive care unit (NICU)
- psychiatric care
- labor and delivery
- medical surgical care
Specialized training could also provide the experience needed for work in a sector outside of healthcare. Not every nurse works with patients in a hospital setting. For example, nursing programs with minors such as nutrition or healthcare management are common. Studying a more business-oriented minor can set BSN graduates up for careers in management – either within hospitals, in other offices of public health, or even in commercial or industrial settings.
Look for programs accredited by the Commission on Collegiate Nursing Education (CCNE) or the Accreditation Commission for Education in Nursing (ACEN). This ensures that the degree meets national academic standards. Enrolling in an accredited program qualifies students for federal financial aid and future licensure, while also assuring future employers that graduates have the skills and training needed to practice with their degree.
Can I study nursing online?
On-campus programs, while widely recognized as being highly beneficial to nursing students, may require you to relocate to attend the program of your choice.
The above table shows the percentage of programs available either completely in person or fully online. Figures that do not add up to 100% indicate the existence of hybrid programs.
Approximately 20% of BSN programs are offered fully online, with the number being higher at private, for-profit schools, at 27.8%. These figures are significantly lower than the national average, but may nonetheless be surprising given that BSN programs almost always include a clinical component. These figures can be explained by the fact that online nursing programs with clinical requirements outsource their rotations to teaching hospitals.
Note that as an online BSN student, you may be responsible for finding your own rotations, supervisors, and proctors, which is an important factor to consider when choosing between an online and in-person program.
The best bachelor’s of science in nursing programs
Find below our ratings of the comparative earnings, costs, and payback rates of different BSN programs.
How much does a BSN cost?
See above how cost and earnings vary depending on the type of institution. Payback refers to how many years it takes students to cover the median costs while earning the median salary. Payback is calculated by subtracting the median earnings of a high school graduate from the median earnings related to this degree.
The average BSN graduate leaves school with a relatively small debt load compared to earnings – $22,327 compared to earnings of $69,567. Another way of saying this is that the debt-to-earnings ratio is 0.32, or 33%. That figure is substantially less than the .48/48% average for bachelor holders in general.
Note that while for-profit schools cost the most, they overperform in terms of median earnings of graduates to the extent that some of these schools might be the best choice from an economic return perspective.
For-profit schools also offer the highest percentage of entirely online programs, at 27%, so they may be the best option to consider if you are looking for an online program specifically.
What type of financial aid can BSN students apply for?
As with most degree programs, the first steps in applying for most types of aid involves filling out the FAFSA form on the Federal Student Aid website. Arrange a meeting with the student financial aid service at your chosen college to uncover options that are provided by the school, or that you may be unaware of.
Loan forgiveness for BSN programs
Many nursing programs are also eligible for loan forgiveness programs, including:
Nurse Corps Loan Repayment Program (NCLRP)
The Health Resources and Services Administration supports nurses by paying up to 85% of their nursing education debt. Registered nurses, advanced practice registered nurses, and nurse faculty are eligible after working for at least 2 years in a Critical Shortage Facility (CSF) or teaching at an eligible nursing school.
Public Service Loan Forgiveness Program (PSLF)
PSLF forgives the remaining federal loans after a minimum of 120 qualifying monthly payments (approximately 10 years) while working full-time for a qualifying employer. Qualifying employers are usually government and nonprofit organizations.
State-level Loan Forgiveness for Nurses
Each state offers some form of loan forgiveness for nurses, so it is a good idea to look into the details for your state. Eligibility, residency, and work commitment requirements vary. You can find more information on individual state webpages.
Army Active Duty Health Professions Loan Repayment Program
Nurses who serve in the Army for at least 3 years can quality for up to $120,000 for repaying nursing loans. A completed BSN and a valid RN license are both required to enlist as an Army nurse. There are also loan forgiveness programs for Army Reserve nurses.
What to expect from a BSN program
BSN programs are generally structured around providing broad practical and theoretical knowledge of nursing care at all stages of life in the form of clinical and scientific skills. The finer points of making decisions and maintaining ethical standards in high-pressure working environments are also covered, as are community and patient education and management and leadership skills.
What are the admission requirements for a BSN?
Entry requirements vary by school and degree format. Be aware that it may be difficult to get into a BSN program directly out of high school because of prerequisite requirements and challenging entrance exams. Many BSN students complete a few years of college in preparation for getting into a BSN program.
Typical requirements include:
- completion of college-level general education prerequisite courses, including at least 1 college-level science course (usually either general chemistry, microbiology, human anatomy, or human physiology)
- a score of 65% of greater on the TEAS (Test of Essential Academic Skills) exam
- passing score on HESI Admission Assessment (A2) Exam
- official transcripts for all institutions previously attended
- letters of recommendation
How long does it take to get a BSN?
A BSN typically takes 4 years to complete.
Clinical rotations and simulations
In addition to diagnosis and patient care, BSN programs incorporate clinical experience. From shadowing nurses to aiding with low-level procedures and circulating through different departments, nursing students gather real on-the-job training to prepare them for entering the workforce as skilled and experienced nurses.
Nursing simulations are increasingly used in the era of online learning. These are usually carried out via specialized computer programs and use a high-tech digital manikin with a pulse, lung sounds, and pupils that respond to light. Students perform various procedures on the manikin while being given specific scenarios by the program.
To take the NCLEX-RN, an associate’s or bachelor’s degree in nursing from an accredited program are required. Accredited BSN programs thus prepare you for this exam.
What type of courses are part of a BSN?
Typically, coursework in a BSN program includes subjects such as:
Nursing care of adults and older adults
This course focuses on nursing procedures, theories, and skills related to the care of adults and older adults. Clinical evaluation and the use of evidence-based nursing interventions are studied, applying cultural and socioeconomic contexts.
This course teaches students to perform physical assessments of patients. Students learn to distinguish between normal and abnormal assessment data, and how to document and communicate patient conditions.
Pharmacology for nurses
This course focuses on the safe administration of medication. Students learn medication classifications, best practices in medication administration, dosage calculation, and error prevention systems.
Community health nursing
This course prepares students to provide nursing care across the lifespan. Students examine the health and habits of individuals and groups across cultural and socioeconomic dimensions and learn community health promotion and disease prevention strategies.
Nursing practice clinical practicum
Many BSN programs will include several practicum courses, focused on different aspects of care and patient populations. Some examples of specialized practicums are: health assessment, pediatric nursing, foundational skills for professional nurses, and nursing care of ill adults.
What types of BSN degrees are there?
Bachelor of science in nursing (BSN)
The BSN is the typical program pursued by holders of associate degrees in nursing and those who have chosen to pursue nursing as their first bachelor’s degree. It is a comprehensive 4-year degree designed to prepare students for a career as a registered nurse.
Accelerated BSN programs
Students who have completed a bachelor’s degree in a non-nursing discipline, and registered nurses seeking to enhance their education with a BSN are eligible for fast-track nursing programs. These are often rigorous and demanding programs for mature students and may take between 11 to 18 months to complete.
RN-to-BSN completion programs are tailored specifically to registered nurses seeking to upgrade their degree. Master’s bridge programs are usually pursued by nurses seeking to enter fields such as nursing leadership or nursing education. Both types of programs usually require a nursing license prior to application.
Careers with a BSN
Registered nurses work under the supervision of the patient’s physician to coordinate and deliver their care. They are often the first point of contact for family members, and they are instrumental in providing patients with instruction on managing their injury or health concerns at home.
District of Columbia
- supervising LPNs, CNAs, and other healthcare personnel with fewer credentials
- consulting with other members of a patient’s care team and coordinating duties
- helping patients prepare for medical tests or surgery
- adjusting treatment plans based on how the patient responded to previous interventions
- monitoring patients’ diet, physical activity, and medication schedules
- taking vital signs and administering medication
- helping doctors and testing technicians perform diagnostic tests
- helping perform diagnostic tests such as MRIs or blood tests
- monitoring and operating several types of medical equipment, e.g., heart rate monitors
How to become
RNs earn an associate degree in nursing (ADN) or a BSN. Employers are increasingly requiring a bachelor’s degree for entry-level RN vacancies. After earning their degree, nursing students pass the NCLEX-RN exam. Depending on the employer and position offered, they may also need certification in basic life support or cardiopulmonary resuscitation (CPR). Nursing students can expect to study anatomy, microbiology, physiology, and social and behavioral science in addition to accruing hours under clinical supervision.
Neonatal and intensive care nurses care for healthy newborns, moderately ill or premature babies, and those requiring extensive medical intervention. The neonatal period is defined as the month directly after birth. However, NICU nurses typically work with babies and children up to 2 years old. The U.S. Bureau of Labor Statistics (BLS) predicts employment of registered nurses (RNs) to grow by 7% between 2019 and 2029. This is faster than the average rate for other occupations. For NICU nurses, in particular, that demand might be even higher.See more
Obstetrics and gynecology (OB/GYN) are overlapping medical specialties that deal with different aspects of female reproductive health. Obstetrics concentrates on childbirth, pregnancy, postpartum, and related fields. Gynecology focuses on other aspects of women’s health from the onset of puberty throughout menopause and beyond. OB/GYN nurses are RNs that typically work alongside OB/GYN physicians. They provide prenatal, postpartum, and reproductive healthcare to adolescent and adult female patients.See more
The nursing profession provides a rare combination of technical, scientific, practical, and interpersonal work. Nurses train in everything from phlebotomy, telemetry, and monitoring vital signs, to how calm a terrified patient with little knowledge of English and manage a crisis situation, while calmly maintaining accurate patient records. According to the American Association of Colleges of Nursing (AACN), BSN-level RNs are expected to embody the professional values of altruism, autonomy, human dignity, integrity, and social justice.
RNs comprise one of the largest segments of the nation’s workforce. They are also among the highest-paid “large occupations” (careers with the largest employment numbers). Although this career offers excellent return on investment, earnings are likely not top-of-mind for most aspiring nurses. Those drawn to this career are usually inherently compassionate individuals with a keen interest in helping others in very practical and essential ways. They are also motivated to work hard and master the technical skills and scientific knowledge required to carry out their work safely and efficiently.
According to the Bureau of Labor Statistics (BLS), the career of registered nurse fall into job zone 4, meaning it requires considerable preparation. A BSN degree is an excellent choice towards a career as a registered nurse.
Do you need a BSN to become a registered nurse?
You can become a registered nurse with either an associate degree in nursing (ADN) or a BSN, although a BSN degree is preferred by employers and likely leads to higher wages.
Do you need an ADN to get into a BSN program?
You don’t need an associate degree in nursing to get into a BSN program, but nursing schools usually have entrance exams and prerequisite requirements that may mean you need to complete a few years of college before getting into a BSN.
Can a BSN be completed part time?
There are part-time BSN programs available, usually taking 6-7 years to complete. These may be a good option for students with full-time jobs and other demanding responsibilities.
What is the difference between an RN and a BSN?
Sometimes, nurses are referred to as RNs (registered nurse) and BSNs (registered nurse with BSN) to distinguish between their levels of education. This terminology is more colloquial than official, and refers to whether a nurse holds an ADN or a BSN.
What is the difference between an RN, LPN, and an LVN?
The title LVN is used in Texas and California, while LPN is used in the remaining states. LPNs and LVNs both have to pass the NCLEX-PN to practice nursing, and work under the supervision of RNs and physicians.
AACN is the voice for nursing education. They establish quality standards for academic nursing, influence the nursing profession to improve healthcare, and promote public support for professional nursing education, research, and practice. AACN represents nearly 840 member schools at public and private universities nationwide.
ANA is a professional organization that looks to protect and further nursing as a vocation and career. They have many resources for both registered nurses and students alike. Joining ANA also gives nurses the chance to connect with other professionals across the country.
NSNA brings together student nurses to help them prepare for licensure and entry into the career. They also promote the development of skills and standards that will further the nursing profession as a whole and can offer scholarships and other forms of mentorship to their members.
With more than 170,000 members in the U.S., the NNU is the largest union for nurses in the country. It was founded in 2009, following the unification of 3 other organizations – including United American Nurses – and protects and advances the interests of nurses and patients alike. Registered nurses should strongly consider joining this union.