We look at the various paths you can take to become a register nurse (RN) and help you choose the right one.

What is the best educational path to become a registered nurse (RN)? There are a variety of options, some being a better choice than others, based upon personal circumstances and career goals.

Nursing Degree Options

Once a popular educational option, there remain very few diploma-only nursing programs in the U.S. These hospital-based programs have slowly faded as college-based degrees are on the rise for the professional nurse or RN.

Current entry-level RNs can earn an Associates Degree in Nursing (ADN) or a Bachelor of Science in Nursing (BSN). ADN programs are usually 2-years while a BSN takes 4 years to earn.

A Master of Science in Nursing (MSN) and advanced practice registered nurses (APRN), which include nurse practitioners, clinical nurse specialists, certified nurse mid-wives and certified nurse anesthetists, can be earned once the prerequisite of a BSN is completed. They require another 18 to 24 months of education and clinical experience.

The Statistics

There are some interesting statistics influencing and supporting the nursing degree discussion. They include:

• About 20 percent of the active nursing workforce originally graduated from a diploma-only program
• Diploma-only graduates represent only 3.1 percent of RNs graduating after 2004
• An Associates Degree in Nursing is currently the most popular program in the U.S.
• Almost half of the current nursing workforce (45 percent) initially graduates with an ADN
• Eventually, 21 percent of ADN graduates go on to earn a BSN or higher degree
• The average time between initially earning a diploma or ADN and matriculating into a BSN program is 10½ years
• At some point in their career, half of all RNs earn a BSN
• RNs initially earning a Bachelor of Science in Nursing represent 34 percent of the present workforce in the U.S.
• Advanced degrees in nursing, MSN or higher, are earned by 13.2 percent of RNs

The Projections

A 2009 study, the Future of Nursing (FON), made several interesting projections or recommendations about the profession:

• Diploma-only programs should be completely phased out of the educational options during the next 10 years
• An Associate Degree in Nursing should be an entry level into the profession but not be a terminal or final degree
• Tuition reimbursement benefits at the workplace should be increased for ADN nurses earning a BSN within five years of their initial graduation
• Hospitals that employ a higher number of BSN versus ADN graduates report better overall patient outcomes
• By 2020, 80 percent of the nursing workforce will have earned a BSN
• Within 5 years of initial graduation from a BSN program, 10 percent of nurses will enter a Master’s or higher program
• Professional organizations, specifically the American Organization of Nurse Executives (AONE) and the American Association of Colleges of Nursing (AACN), plan to mandate a BSN as the entry-level degree
• By 2020, the number of doctoral-prepared RNs will double; there are currently 217 Doctor of Nursing Practice (DNP) programs offered throughout the U.S.

Moving forward, the rising patient acuity coupled with the changing landscape of the medical profession dictates the level of professional nursing care required.

Healthcare Trends

Healthcare is trending to less hospital and more home-based care for a two main reasons:

• Patients, or a health care proxy, determine the course of their own healthcare and want to remain in their own home for as much care as possible
• Health insurance reimbursement, or lack of same, often determines where a patient will receive care, especially when expensive therapies are involved, like physical or respiratory therapy

So, in order to determine the course of nursing education, the profession in general needs to evaluate what to teach, how to teach and where to teach the future nurses in the U.S. It is after that time that an individual can begin to choose the appropriate and best program to meet their individualized professional goals.