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The BSN by 2020 push: How close are we to achieving this milestone?

Editor’s note: This content is brought to you by South University.

How close are we to an 80% baccalaureate-educated nursing workforce?

With 2019 coming to an end, nurses are asking where we are in meeting the goal set by the landmark 2010 Institute of Medicine (now the National Academy of Medicine) report on the Future of Nursing to have 80% of practicing RNs with a BSN by 2020.

Thanks to the hard work of truly amazing nurses and other healthcare professionals, during the past decade we’ve made important, positive strides.

BSN by 2020 starts after decades of debate

The year 2010 was significant after a long history of efforts aimed at uniform nursing education preparation.

For many decades before the IOM report, there was an ongoing debate within the profession around the question: “Is the BSN the decisive credential for licensure and entry into practice?” Attempts at coming to consensus were unceasing, and there were many starts and stops along the way.

BSN by 2020 - Nurse's hat with single black stripe. See additional images below for other possibilities.
As far back as the 1920s, in an attempt to move nursing into mainstream university education, the historic Goldmark Report called for the BSN to be standard preparation for entry into practice. Later, the advent of the associate degree in nursing in the 1950s reopened talks on the subject, and later still the question was addressed in the well-known 1985 proposal on nursing education.

The debate continued through the following decades and into the new century, and the 2010 IOM report brought nursing together around a host of big professional and educational goals, one being the recommendation that 80% of practicing RNs have a BSN by 2020.

Upon its release, the report indicated approximately 36% of RNs were entering nursing with a baccalaureate degree. But because many came with a diploma or associate degree and later earned a baccalaureate, there were about 50% of practicing nurses nationwide in 2010 with a BSN.

Work done, lessons learned

BSN by 2020 - Graduation hat and diploma on wooden backgroundIn November 2010, the Robert Wood Johnson Foundation initiative called The Future of Nursing: Leading Change, Advancing Health took up the baton, established the Campaign for Action, and did a mammoth amount of work, helping to increase the nationwide percentage of baccalaureate-educated nurses from 49% in 2010 to 51% in 2014, moving toward the ultimate goal of 80% BSN by 2020.

Various other professional nursing organizations, such as the Academic Progression in Nursing (APIN), which is funded by RWJF and led by the Tri-Council for Nursing, joined the effort. Other organizations included the American Association of Colleges of Nursing (AACN), the American Nurses Association (ANA), the American Organization of Nurse Executives (AONE) and the National League for Nursing (NLN).

Certain states were selected by APIN from 2012 to 2014 for funding that would be used to advance their work on academic progression. RWJF invested more than $9 million in the program by the end of 2016 and nine states (California, Hawaii, Massachusetts, Montana, New Mexico, New York, North Carolina, Texas and Washington) were participating by that year.

Then in 2017, AACN circulated a position statement draft called, The Baccalaureate Degree as Entry-Level Preparation for Professional Nursing Practice,” to get public opinion on the issue. In part, AACN said it “believed registered nurses should be minimally prepared with a BSN or equivalent nursing degree,” and the position statement mentions how the IOM’s BSN by 2020 goal has “generate momentum” toward that goal.

In an article, Robert Rosseter, chief communications officer for AACN, clarified the draft did not say nurses could not enter the profession with an associate degree. “The focus here is on academic progression — moving nurses on to higher levels of education,” he said in the article.

BSN by 2020 - stairs going upward, 3d rendering

Many goals achieved

  • Progress continues, outcomes remain positive, and nursing continues to move forward in growth of four-year programs, which went from 882 in 2002 to 1,413 in 2012.
  • The Campaign for Action is still learning from the states as they work at the national level.
  • State action coalitions and implementation programs have been successful, as have strategies to advance academic progression.
  • The campaign has provided technical assistance on academic progression to 25 state action coalitions and implementation program grantees, in the belief that “standardizing prerequisites and general education requirements across the nation in all nursing programs is a fundamental step in advancing nursing education and removing barriers that make it difficult for nursing students to move from an associate degree in nursing to a (baccalaureate) program.”

Almost time to celebrate!

According to two leaders during this decade-long process — Susan B. Hassmiller, PhD, RN, FAAN, senior adviser for nursing, Robert Wood Johnson Foundation, and director, Future of Nursing: Campaign for Action, and Susan Reinhard, PhD, RN, FAAN, senior vice president and director, AARP Public Policy Institute and chief strategist, Center to Champion Nursing in America — the new National Academy of Medicine report soon will be released and its findings discussed at a gathering of action coalitions and other leaders in healthcare.

This will give everyone an opportunity to celebrate the work that’s been done and measure how much closer we have gotten to 80% BSN by 2020 and other important recommendations.

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By | 2020-01-13T11:41:17+00:00 November 20th, 2019|Categories: Nursing careers and jobs, Sponsored Content|19 Comments

About the Author:

Eileen Williamson, MSN, RN
Eileen Williamson, MSN, RN, continues to write and act as a consultant for Nurse.com. Before joining the company in 1998, Eileen was employed by North Shore-Long Island Jewish Health System in New York, where she held a number of leadership positions in nursing and hospital administration, including chief nurse at two of the system’s member hospitals. She holds a BSN and an MSN in administration, and is a graduate fellow of the Johnson & Johnson University of Pennsylvania Wharton School Nurse Executives program. She also is a board member and past president of the New Jersey League for Nursing, a constituent league of the National League for Nursing.

19 Comments

  1. Avatar
    Ashley M Valentine November 30, 2019 at 10:33 pm - Reply

    Article is titled how close are we and still never said… very click bait title if I say so myself.

  2. Avatar
    Tracy Seymour December 2, 2019 at 2:44 pm - Reply

    I have been an LPN for over 20 years. I think that 80% of RN’s having 4 year degrees by 2020 is an unrealistic goal. I can understand if an RN wants to get a certification to specialize in a particular area of nursing, then a 4 year degree is necessary. For example, I live in Minnesota, and the pay difference between an ADN RN and an RN with a bachelor’s degree working in a hospital is less than 2 dollars. What incentive is that to achieve your BSN? Why accumulate more student loan debt for $2.00 an hour more? I can understand if an RN wants to be a public health nurse, etc., then getting your bachelor’s degree in nursing is a good idea. Just my opinion…

  3. Avatar
    Carol Schmidt December 4, 2019 at 8:39 am - Reply

    I have never seen a facility in my area that has any differential for having a BSN. Two dollars an hour would be wonderful! But I, like many other nurses, are feeling the terrible burden of student loans that we took to get that degree with no return on investment. If I had to do it over again I am not sure that I would have gone on to school. I see all the ADNs that I graduated with many years ago, earning the same, and free from debt. They had better lives than I have had because of the time and money I put into a degree that at the time seemed so important.

    • Avatar
      Deitra Gates January 19, 2020 at 12:36 pm - Reply

      To join your comment, I have not seen a facility with reduced FTR rates. Look at the news. By pushing the BSN, as entry to practice, you get brand new RNs who trained in SIM labs or who wrote papers, in lieu of actual patient-touching clinical experience. Nursing schools can teach them to pass NCLEX, but patients die due to poor clinical and critical decision making.. Clinical experience is being sacrificed. As a result, new nurses, including BSNs are not practice ready. NCSBN supports this and is changing NCLEX-RN to NextGen to include questions that can gauge a candidate’s critical thinking, clinical judgement and decision making. Nursing education is to blame for this fiasco. You have nurses talking about “bedside” nursing is not for them so they are going straight for NP. What have we done? Hire a well trained nurse even if they are diploma or ADN. Let them work and get experience while earning a BSN. You will have a reduced FTR. (Failure to Rescue).

  4. Avatar
    Cynthia Pinkston December 16, 2019 at 9:08 am - Reply

    I’ve been hearing this nonsense for years. I have a ADN and am just as informed on patient care as the BSN nurses that I have worked with. In fact most of the BSN nurses want an office job and get it eventually. I have no student loan debt while many of them are paying off theirs. Also there’s nothing I hate worse than some office manager with her BSN dictating to the floor nurses how to care for patients while having done no direct patient care in many years. I’ve been in nursing for over 30 years and can’t wait to retire from this profession because of management in many jobs I’ve had throughout the years. I worked with a nurse recently with a Master’s in nursing that couldn’t even put a catheter in a patient or a rectal tube. Why? Because many of the nurses with advanced degrees don’t want to work in direct patient care and I’ve heard many of them say it. I’ve made a good living with my associates degree, can’t complain. I think it’s a marketing ploy for the universities.

    • Avatar
      Deitra Gates January 19, 2020 at 12:39 pm - Reply

      I agree! There should be stronger requirements for advanced practice nursing such as a minimum of 3 years as an RN. I see nursing students on FB saying that they don’t want to work medical-surgical, but go straight for NP. We have created monsters.

  5. Avatar
    David December 17, 2019 at 6:28 am - Reply

    What’s the sense of a BSN anyway? I agree with others that ADN is good and adequate in an industry that needs to not worry as much about degrees over patient care. Nursing hasn’t grown as a field in which members are unified on issues. These issues include patient care, staffing ratios, violence to nurses, adequate pay for BSN degree. I have a ADN, MBA in health management and BS in Community Health. I have been an DON and worked in Occ health, wellness. I am serious that if someone can convince me that I will benefit from a BSN, I will apply soon. The part of the BSN piece that frightens me is if the nursing industry begins to move towards not recognizing ADN vs BSN degrees. I understand the movement within nursing as PT and Pharmacy field has moved toward doctorates, but where is the added value for the patient vs. the field? It’s a waste of time and resources at this point.

  6. Avatar
    Matt January 14, 2020 at 12:28 am - Reply

    I work for the VA, and promotion past the first few pay grades requires a BSN or a close equivalent. I’ve looked into BSN programs after taking BADNAP course (10 month ASN course for people with a prior Bachelor’s) and a good many of them require no time in a classroom or a clinic. The courses focus on leadership and research which seem to set you up to sit behind a desk more than they make you a better nurse at the bedside.

    We’re still at a huge deficit when it comes to nursing jobs and hospitals know that any advantage to having a BSN on the job is more than mitigated by having empty positions in wards attempting to achieve an arbitrary goal. But as the article states, the number of BSNs grew a whole 2% from 2010-2014. At that rate we’ll hit the magic 80% marker by… 2110.

    I’ll consider the getting a BSN if the pay increase offsets the money I’d have to invest; but unless there’s schooling in a specialized field I’m interested in, I doubt my skills will magically increase while typing on a keyboard at home.

  7. Avatar
    Lorea lewis January 18, 2020 at 7:05 pm - Reply

    With the lack of work ethics,committment, and accountability amongst nurses.Many facilities of a rehabilitation or LTC nature have such a lack that many managers are working a unit
    So the BSN may not keep anyone behind a desk with these ongoing issues.

  8. Avatar
    K Overmeyer January 19, 2020 at 11:17 am - Reply

    It depends on your personal goals and where and if you want to advance..stay at the bedside and in a hospital at that pay wage is perfectly fine. because we will always need a bedside nurse and we want those to be the very best there is!! Kudos for staying there! Making over $100,000 a year with a choice of working just about anywhere as a Nurse Practitioner…that is where the motivated flock to, where an entrepreneur in nursing wants to be (yes there are actually national organizations specifically for Entrepreneur Nursing.) Where ever you are, whatever your comfort level, whatever economic status you prefer to aspire to, or remain at, whether you are a single woman without family or the breadwinner for a family…all those variables feed into your decision. The issue is not who is better, ADN nurses are priceless. Feel free to stay where you are but realize that there are states that do pay a significant difference and do offer rewards for those with higher education. (Magnet Hospitals for example). I personally never wanted to be restricted by title, never wanted to NOT have the choice to compete in the market, never wanted to NOT have the opportunity to travel and teach and be active on national committees. To be able to do that kind of thing means investing in oneself in a different way. Being happy with where you are is key, but nurses let Administrations walk all over them and do not advocate for better pay or better benefits and too often believe they have no voice. Lots of griping on this topic but little to no action from the trenches where good care hinges on acuity and staffing. Ask yourself every day, what did you do to advance your profession overall? The rest of us with Masters Degrees or DNP will continue to advocate for the advancement and options available to those with higher-level critical thinking skills, different leadership skills, and the ability to choose any field, any time, any place. I guess you could say that those who advance love change and challenges beyond having the same job for more than a few years. I have been in nursing for over 40 years and have loved every single new job and advancement and pursuing life-long educational opportunities. It is the drive and the journey in learning that is the real motivator here…we get bored easily! And the reward for wanting to grow? A great salary range potential and the ability to go anywhere in the US, especially now that NPs are becoming Primary Care Providers in all fields and specialties. Awesome!! With telemedicine, the choices continue to grow! That Nurse Anesthetist putting you to sleep? She was someone who was too constrained at the bedside. Thank God also for those who advance to lead those who like to be led…everyone has a place. Enjoying your place and loving your choice does not heed to be justified to anyone. We need to be supporting all levels and working together to provide the best care, the safest care, and own who we are proudly. But, the goal is still BSN. I hear this so much from my AD students who go on to their Masters…you do not know what you do not know until you gain higher education.It is not for everyone. I have relatives who have never left the tiny town I could not wait to get out of in Ohio in 1971 after graduation. They ae happy as clams! What is the difference between that and being happy in the level of nursing anyone chooses to stay at?

  9. Avatar
    Susan Craig January 19, 2020 at 11:46 am - Reply

    I have a lot to say about this subject. Let me start by saying that I obtained my BSN 36 years ago when student loans were not outrageous. I have always been a bedside nurse and will be until I retire. Over the years, I have had the privilege of working with nurses who had 3 year degrees and numerous LPN’s. These nurses were as qualified and skilled as I was at taking care of our patient population(NICU). I started hearing about the push to have your bachelors several years ago at about the same time people started talking about the coming baby boomer retirement mass exodus. So, several of the 3 year programs around where I live have closed and it’s almost exclusively 4 year bachelor programs. By doing this, the push for BSN nurses, I feel a lot of women who would have become a nurse by getting their 3 year degree, went on to other fields because they did not have the time or money to obtain a BSN, thus reducing the number of women going into the nursing workforce. This, at a time when we are facing a huge reduction in the nursing workforce because of baby boomers retiring.
    I also have negative feelings about “Magnet” hospitals requiring a certain percentage of BSN nurses and APN. My negative feelings with Magnet started when a surveyor asked a room full of nurses, what accomplishment they were proud of. Most of the other nurses were bragging about going back to school or other endeavors that didn’t involve direct patient care. My proud moment was being the primary nurse of a baby for a significant amount of time(16months) and teaching the young mom had to be a mom and how to take care oh his complex needs. The surveyor was over the moon about the other stuff that was mentioned but she barely batted an eye at my accomplishment. So right there, I realized that Magnet’s focus wasn’t about direct patient care but how good we can make the nursing profession look by having a large number of BSN and APN nurses.
    In the last several years, I’ve noticed that the push is now to not only obtain your BSN, but to go on and obtain your APN degree. It’s just not good enough to stay a bedside nurse; the nursing graduates now are expected to go on and obtain their APN degree. So, at this time, when we are facing a nursing shortage, the nursing profession is shooting themselves in the foot by putting a huge focus on BSN and APN degrees. Don’t get me wrong, there is nothing wrong with an BSN or APN degree but I just wish some more focus is put back on the value of bedside nursing. If all the young nurses go on to become APN’s, who is going to be left taking care of patients at the bedside?

  10. Avatar
    Andrea Conover January 19, 2020 at 2:09 pm - Reply

    Bring back diploma schools where students actually have experience at time of graduation. I went to a diploma school and got my BSN 10 years later but I don’t feel I gained anything for having it other than maybe job security.

  11. Avatar
    Scott January 19, 2020 at 9:51 pm - Reply

    So??? How close to 80% are we? Still never got an answer.

  12. Avatar
    Karin Nassenstein January 19, 2020 at 11:13 pm - Reply

    This pisses me off. To get my BSN costs so much money with no real benefit. On top of that to say that people with an ASN are not as qualified as a BSN because the biased statistics say that they are better nurses can kiss my …..
    Just because a BSN can write good papers has nothing to do with patient care. I can give just as good care.
    The fact that these BSNs think people with ASNs are stupid is crap…
    Especially since i took the same damn test that they do, passed it my first time around. So if i took the same test as a BSN what is the friggin difference outside of the fact i can not write a good paper.
    UGH UGH
    If they focused on more patient care so it makes me a better nurse, than maybe but i do not want to be a leader not now not ever. I think it should be based on what we want to do in the future not based on how to write a good paper or learn how to be a leader maybe..
    But i do not see the difference between an ASN BSN outside of writing good papers.
    As for critical thinking i am very good thank you very much.
    I personally also think this is prejudiced….because i am just as good as any BSN

  13. Avatar
    Eve Salinas January 19, 2020 at 11:14 pm - Reply

    They have been talking about this since I became a nurse in 1981. It hasn’t happened yet. Why have nursing boards not made the BSN as entry into practice? I started out as associate degree nurse then went on for my BSN. After that I went on for a MSN. Why has it taken so long to upgrade the level of nursing education? Each level of nursing offers valuable education and further professionalizes its member. Salary wise the hospitals must offer a salary that commensurates with the additional education and also help nurses to continue their education by providing tuition reimbursement.

  14. Avatar
    Oh Please! January 20, 2020 at 1:46 am - Reply

    I have been in the field since 2002 (CNA) got my LVN in 2003 and learned possible side effects/adverse side effects on medication administration, proper sterile technique with tasks (foley care, IV insertion *without* the fancy gadgets) proper order entry + carry out. I sat as monitor tech, LVN with IV insertion verification on a very busy Telemetry floor I loved. I had real charge nurses that would fight for the safety of our patients and nurses with admitting offices that tried pushing patients in. We (nurses) were able to build quality care with establishing rapport, trust, true bedside manner with the patients we had on hand. With my six year LVN experience I was granted a high intensity 18 month bridge program: LVN to RN-ADN in 2008.

    I carry the true ethic and art of nursing with my ADN. The BSN programs teach nurses about business. The BSN nurses I have experienced lack integrity with their patients, are simply task-driven and have no time management, no respect with the art of nursing (Florence N. would be ashamed) and they will discharge patients unsafely, feel entitled that they do not have to answer call lights. They have increased infection rates because they do not do pericare with foleys, they do not clean patients crusty eyes before applying eyedrops, do not teach patients on how an actual suppository works and let the patient run to the toilet once they feel the urge in their rectum when they are suppose to *squeeze the butt muscles* so that the actual product can migrate to the lower intestine. All this increased hospital stay in regards to all the above mentioned. The graduates that went straight into their BSN from high school are giving IV Protonix too fast and sending their patients into tachy-dysrhythmia! They give their meds, sit down on their iPhones and “chart” talk crap about other nurses and get complaints from MD’s about their incompetence on the floor. Do they try to understand their patients? Some. 90% do not. They whine, complain, and move elsewhere because they are inhuman, act like high school kids that just want to gossip. These nurses are are then hired to bully other nurses from their managers. The increased patio rate has had significant losses: deaths, falls, death by falls, increased re-admission rates and therefore a once well known tertiary care facility has lost its phenomenal “crown” of being one of the best Los Angeles Medical Centers in town.

    The BSN’s put their hands in the air and say “there is nothing we can do” as they agree to dump patients anywhere there is a bed. The BSN case managers are the worst yet with their business minds. God is watching and hopefully you will have a good nurse and will learn that your business mind in this business is killing your patients and nurse morale. Thank you BSN, not only for engaging in placing these poor and incompetent nurses in debt they will have to pay for the rest of their living life. No wonder they don’t care – they just want the money to pay their debt or Gucci.

    They only way I would get my BSN is it was paid for. I am not falling for that gimmick. God is watching – stop pushing nurses to think business when they need to take care of your family members. BSN is true BS when you do not have the experience. Sip on that.

  15. Avatar
    Keith January 20, 2020 at 9:54 am - Reply

    Having a BSN and working with ADN’s and LPN’s, I have been humbled by the excellence that they bring to the field. On the other hand, I have worked with BSN’s who don’t seem to know the 1st thing about patient care. I agree, this title promised much more than the article delivered and I don’t see a reason to ‘celebrate’ from what was said.

  16. Avatar
    Monica Posani January 20, 2020 at 3:27 pm - Reply

    after 40+ years in nursing I am now sitting on the sidelines. My entry into nursing was pretty smooth because my education and clinical practice prepared me for hospital floor nursing. When I was a third year student, I worked in the hospital 3 days a week and had classes the other 2 days. When I started my first job, it was on night shift and I learned a lot from a very experienced LPN. Every job I have had, I have grown in my knowledge and experience that no amount of college education would have given me. What I have noticed about the people just entering the profession is their disregard for our (nurses’) history. Our schooling included a history of the profession and respect for our history. We wore caps to show our pride. We were taught to dress professionally with clean uniforms, shoes, neat hair, minimal jewelry (wedding band). Now, nursing students attend classes in shorts and flip-flops. When it comes time for work, they used to dress inappropriately, with nail polish and gaudy jewelry. I swear this is why the hospital where I work adopted a policy of all nurses wearing scrubs that different colors designated your position in the organization. This is the way management could enforce a dress code without singling out any group or preferences. (I once saw a floor nurse who was pregnant with low slung pants and a short top, which left her belly exposed. This was at eye level with a patient in the bed.) Nursing was good to me. I met incredible people, worked in several nursing areas, and I am still in awe of what is being accomplished by nursing and research (the possibility of transplant a liver that had been infected by hepatitis!) I did not consider furthering my textbook education because I learned a lot more from my work than I would ever learn in a classroom. I am proud of my cap and my diploma.

  17. Avatar
    Mr. Lee January 21, 2020 at 2:36 am - Reply

    Not one patient or doctor ever asked me or any nurse I know whether they had a diploma, associate’s or BSN. We all take the same licensing exam. How narrow-minded is it when the letters after a nurse’s name becomes more important than experience and specialty certifications that denote high proficiency in certain areas of nursing.

    Give me that diploma or associate’s prepared nurse with 20+ yrs experience and specialty certification in critical care any day over a BSN who has spent more of their education writing papers than in clinical training. Experience and competence trumps initials any day.

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