ADN/RN route to BSN vs traditional BSN

College Majors Nursing Major
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ADN/RN to BSN vs. AS to BSN/RN. Pros and cons?

My son is having to make this decision early since he is attending a Healthcare Collegiate Academy (early college high school). The ADN seems like fantastic opportunity to get his ADN/RN quick and easy and for free since this is a public high school program via a partnership with the community college and then afterwards he could do one of the bridge to BSN one year programs. Then a DNP.

However it certainly limits his career options since the ADN is a “vocational degree” whereas AS is a transfer degree.

The AS keeps his options open and creates a shorter road for any major outside nursing, but makes the road to BSN/RN longer if he decides to be a nurse. The ADN limits his options and makes a longer road for any major outside nursing, but makes the road to RN and BSN shorter.

I understand only he/we can make this choice. But I welcome opinions and things to consider as we make this choice with our 14 year old.

He has 5 high school pathways to choose from (AA, AS, ADN/RN, Surgical Technican, LVN). He is torn between AS and ADN.

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Does he know anything about what nurses do all day??? Start there.

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He is interested in healthcare and nursing. His exposure has been as a patient so far- and guest speakers at his program. He is in the middle of his first year. He will get plenty of exposure over the course of the program. But he does have to pick a pathway. Then he will get more exposure. Same as I did in my career.

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Nursing is a great career with many options and pathways. If he can get the ADN/RN while he is in high school, via a community college while in high school program, he definitely should. It’s worth two years of college and probably 15-20K in tuition and fees to him. I’m assuming that he will be 18 yrs old before he is graduated from high school? And that he would be able to finish the ADN/RN by the time he is graduated from high school? Then he absolutely should do that, and at the same time should be investigating the transfer to a 4 yr college’s shortened ADN/RN to BSN program. He should plan on working as an ADN/RN for at least a semester, and maybe a year, before he enters the shortened ADN/RN to BSN program.

He will miss out on the college experience of making lots of friends while living at college as a freshman. That’s both good and bad - there’s a lot of bad behavior that goes on, sometimes with tragic consequences. But he’ll be able to earn a good living from right after high school, and a better living two years after that, and possibly a great living by the time that he’s about 23. Contrast that to the traditional 4 yr BSN starting at age 18, plus a couple of years of work, and then the NP or DNP program, which all would put him done by about 25-26 at the earliest.

Look into his getting his CNA this summer, so that he can start doing some CNA work. It’s the dirty work of nursing. These days, a lot of the practical nursing care is done by CNAs, with an RN or BSN supervising several CNAs. If he absolutely despises CNA work, then maybe he should go an alternate route, like surgical tech, and do shift work while he goes to college for something else.

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Thank you! Yes his program automatically includes CNA and PCT for all students on all pathways! I forgot to mention that.

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Yes.

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This is exactly what I was thinking there is just this tiny niggling doubt that says if he ends up not wanting to do nursing then his ADN will have so few transferable credits (outside of nursing). It has hardly any core general classes. It is an Associates of Applied Science, Nursing. I am going to talk with his guidance counselor to ask if he starts the ADN and decides nursing is not for him, can he switch to the more general Associate of Science degree for the remainder of the program so he would have more transferrable core classes for a BS in another major at a university. Just want to have an exit strategy if he changes his mind. He is making this decision at a younger age than most.

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I would check the current hospitals in the area to see who they are hiring. Where I live, many health systems have gone to only hiring BSN’s or RN’s currently enrolled in an RN to BSN program.

It’s not like this everywhere but would definitely look into it.

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I understand. Yes he would go on to get the BSN afterwards by enrolling in the RN to BSN program. He just has this option to get the ADN/RN first while in high school for free and then do a one year RN bridge to BSN after graduation. My son is thinking about going on to get his DNP to be a nurse anesthetist ultimately.

But they do hire ADN/RN’s here in Texas. Some facilities prefer/limit to BSN but plenty hire ADN/RN’s. I have a good friend who is an ADN/RN. She has never had any trouble getting work at multiple facilities in our area over the years.

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With an ADN/RN, he can work as a nurse, even though some jobs do prefer BSN. This can allow gaining some nursing experience and getting a feel of what nursing is like before committing to a post-high-school educational path, in addition to earning some money to pay for future school.

Also note that if he completes the ADN/RN by high school graduation, he would have the option of applying to most colleges as a frosh if he decides to switch to something else instead of doing an RN->BSN program. However, if he does switch to something else, note that ADN/RN course work may not be applicable to some other paths (e.g. pre-med science requirements).

The other thing to consider is that regular BSN programs tend to be highly competitive for admission (either frosh direct admit or secondary admission). Direct admit programs may also have high GPA weed-out policies. It is definitely a riskier path to BSN than the two-step of ADN/RN first followed by RN->BSN.

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Yes. Good point. This is another factor.

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If what he wants is to become a nurse anesthetist, then he will have to do some ICU nursing first. That’s who they take for nurse anesthesia programs, because they have a lot of familiarity with managing ventilated patients, some of whom are also on cardiac meds, and have other very complex issues. They’re the ones who have a lot of experience with nursing critical care patients. They like to take these nurses because they already understand a lot of what is done to manage a patient during surgery. So if that is what he wants, the path would be probably a year of floor nursing while he applies for the RN to BSN program, then after he gets his BSN, back to floor nursing while trying to get into the ICU. Then as many ICU type positions as he can get (cardiac, neuro, pulmonary, etc) while he investigates nurse anesthesia programs and applies.

You’re right, in that if he decides he doesn’t want nursing, but wants something else, he would have to take a lot of other classes. But frankly, if he were to go for the AS and decide he wants to take something else, probably only a year of his coursework would transfer (the gen eds) and he’d still need to do at least 3 yrs more towards any other major.

To me, it seems that this is an excellent pathway. Absolute WORST case scenario: he finishes the ADN/RN at 18, and then goes to a 4 yr college to study anything else he wants. He’s finished high school with an employable qualification, better than if he’d just gotten a high school diploma.

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You’re right. My daughter has about 30 credits or so from dual credit and AP and some of them aren’t on her degree plan (Texas A&M - BS in Visualization) so they won’t count and even the ones that do will only lighten her load but her major has 8 semesters worth of sequential studio labs so students can’t graduate in less than 8 semesters regardless of how many credits they bring in.

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There might be hospitals that offer critical care internships to new grad RN’s. I’d also check around to see if hospitals near you have them and what they require to apply. They are great programs that provide both classroom type learning, as well as clinical learning where you are paired with a preceptor for about 6 mos. - all while getting paid. They are highly sought after positions for new grad RN’s. Would be nice for him if he can land one of these after he gets his RN license if he is looking to become a CRNA. They typically then require an agreement to work in the ICU/CCU for 1-2 years since they provide a lot of hands on training (ACLS, IV cert, how to manage vasopressive drips, cardiac drips, vents, central lines, etc).

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I would absolutely want ADN/RN for free by hs graduation then do a bridge program. I work in peds rehab with a bunch of ASN’s (one of the non nursing home jobs in the region who hires ASN) who went to Capella for cheap to get their BSN in less than a year. Once they got the credential they had no problem getting jobs in top hospitals especially during the pandemic. One just graduated as an anesthetist. Even if he decides he doesn’t want to be a bedside nurse, having a BSN opens up many job opportunities in other industries like insurance, occupational health agencies, government etc.

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How certain is he that he wants to be a nurse?

It sounds like your son is still in high school and has the opportunity to complete an AS early, so I don’t see the rush. He’ll still spend the same amount of time in school as if he majored in someone else, and getting a transfer degree keeps his options open. If he’s just now starting, I’m guessing he’s between 15 and 17 - that’s pretty early in life to lock yourself into a specific career path. I think there’s also major value in the developmental phase of college outside of just vocational training - especially for a nurse, who may be dealing with people who are having some of the worst experiences of their lives. Some life experience and perspective can only be helpful.

That said, nursing is a thriving career that will always be needed and a great base for a variety of other careers (I know at least two former nurses who work at my tech company, in two different roles, neither related to healthcare tech). And I’d understand if money was a concern. (However…I would like to emphasize that with this route, assuming he’s 16 now, we’d be talking about a practicing nurse at between 18 and 20 years old, and he may have a hard time finding a job that young…)

Either way, I have a lot of family in nursing (including my mother and several close cousins), and I’d strongly recommend that he works a few years after getting his BSN. It’s a practical degree, and it’s meant to be built on top of a foundation of experience in nursing. I think many hospitals would be wary to hire a DNP without any actual nursing experience - you can’t go into the nurse leadership roles that DNPs usually inhabit, as none of the other nurses would ever listen to you (nor could you manage them), but you’d be too expensive to employ in a regular nursing role that they could just hire a BSN for.

Also - he has to think about his future career in nursing, not just the situation right now. While ADN/RNs may be getting hired right now, especially because of the pandemic, the field is moving towards a BSN being the base for the nursing career. It carries many benefits for patient care.

My mom made this mistake in an earlier era - she went to a diploma program to get her LPN at a time when LPNs were still getting hired but many facilities were moving towards hiring only RNs. While she did get hired, she found that she got the worst shifts, low-level tasks, and she couldn’t advance in her career there - her lack of an RN was holding her back. She also got paid a lot less than the RNs (and a LOT less than the BSNs). She can’t work anymore, but if she could, I think she’d have a hard time getting hired in a hospital - and she’s said as much herself. (She worked as a school nurse before she became disabled.)

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Yes he has no plans to just work at the ADN/RN level for very long. He would go on for a BSN. Originally we were thinking the more general A.S. then do the traditional BSN (or something else) and that is what we put on his application when he applied to this Collegiate Academy last year but then we found out he can get the AAS/RN by high school graduation then bridge to BSN after that and that the RN to BSN program at the university only takes a year and only costs about $9,000. Then work as an RN for awhile and eventually to to a CRNA program. The decision is made now because it determines coursework for the rest of high school. So now he is in the third quarter of his first year (8th grade) at the collegiate academy and they are being asked again what pathway they are moving forward on because it determines their schedule for next year. They make the schedules in Feb for fall. For example, he is in honors algebra 1 this year and If he is going to do the Associate of Applied Science, Nursing degree he has to take Algebra II this summer vs if he is doing the Associate of Science he doesn’t do summer school and will take algebra II later next school year. From what I can tell it is easier to switch from the AAS to the AS rather than the other way around. So if he decides it isn’t for him, he could switch back to the more general AS pathway.

To your point, that is exactly my conflict. He says he wants to be a nurse. He is the one who told us he wanted to attend this new Healthcare Collegiate Academy in our district instead of the regular high school that our oldest attends and she is off to Texas A&M next year for a more traditional college experience. But he is young. So I am thinking about what if he changes his mind? So, I’m torn about him being locked into a career path so young. On the other hand- great opportunity as I have heard of so many people here who don’t get into nursing school the traditional way. It is very competitive at most schools around here to get into the nursing program. They get accepted into the University but don’t get into the nursing major program so they have to change their major or transfer. (Texas A&M, UT Austin, etc)
And I say locked in, cause it feels like it a little, but he’s not really locked in, he could change pathways/majors.

Even at the regular high school my daughter had to make similar decisions in 8th grade. Here in Texas they have to pick an endorsement in One of five areas: STEM, Arts/Humanities, Business , public service, or multidisciplinary. And it determines their coursework. I remember it felt so limiting and restricting to choose one! I said multidisciplinary and the guidance counselor said no they discourage that and then we had to choose between STEM and Arts/humanities- but she’s good at both! She picked one but ended up earning three endorsements. :grinning: STEM, Arts/Humanities, and Multidisciplinary!

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He’ll never be “locked in”. He can always change his career path. This generation is told to expect to change career paths during their lives - perhaps more than once.

As suggested, the RN to BSN is a great credential. Nurses have many career paths outside of direct patient care. Insurance companies hire nurse in a variety of capacities. Pharmaceutical companies do the same. Nurses can advance into management positions both in hospitals and elsewhere. Any of those options and more may require an advanced degree or other credential, but that is true in any field.

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Sure, he’ll never be “locked in” - that’s perhaps a poor choice of words. In my case, I more meant that more effort would be required to change pathways in the short term. For example, as the OP highlighted, the ASN isn’t a transfer degree - so if her son got the AAS and then decided he wanted to major in history and go to a traditional four-year college, he may have some coursework he’s got to make up.

However, OP, with your update clarification (that it’s easier to switch from AAS to AS) and the deciding factors (whether to take algebra II over the summer), I think he should go for it. Accelerating in math is never a bad idea, and it sounds like he has more flexibility than I thought he’d have. He’s at the stage where he has to make more of his own choices, so especially when they are relatively low-risk, I’d let him make them.

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