Associate Degree Nursing Programs: A Solid Foundation for Baccalaureate Education (Part 1)

By Caroline K.  Mosca PhD, RN

Every story in the mosaic of history has a beginning, a cast of characters, a set of
social circumstances, and its own momentum. The development of a new, two year
program for educating professional nurses during the years just after World War II is
no exception. (Haase, 1990, as cited in Schekel, 2009, p. 34).

Associate degree nursing programs were established as a temporary solution to a post-World War II nursing shortage and continue to be a solid foundation for entry to practice. They were not originally intended to be a permanent component of nursing education, however, their value as a cost-effective, readily accessible means to a nursing degree was immediately apparent. The emergence of many associate degree nursing programs shifted nursing education to community colleges, and thus, the geographical boundaries were expanded far beyond hospital- based diploma schools and baccalaureate university programs. It brought nursing education to the community setting. Many more students could complete nursing programs and enter the work force in a mere two years. Fast forward to 2017 and we see that the nursing shortage following World War II never truly went away. Consequently, associate degree nursing programs have continued to thrive as a foundation for entry to practice.

The associate degree nurse continues to play an important role in health care in the United States, but recent research has demonstrated that a baccalaureate education is associated with better patient outcomes (Aiken, Clarke, Sloane, Lake, & Cheney,2008; Aiken et al., 2014). Although the skills taught in both associate and baccalaureate programs are similar, the focus on liberal arts in a baccalaureate program promotes critical thinking skills that are essential in a fast paced, complex, and chaotic health care system. The Institute of Medicine (IOM) has recommended that the nursing workforce be comprised of 80 percent baccalaureate nurses by 2020, and many hospitals have taken up this charge and instituted timelines for expected completion of a baccalaureate degree (IOM, 2010). However, it is doubtful that the goal of 80 percent will be met, although there is a positive trend in that direction. In 2013, 55 percent of the workforce was baccalaureate prepared, but in 1980, only 22 percent were (AACN, 2017; HRSA, 2013). We have come a long way in a relatively short time period, but there is still work to do. If we are to continue to increase the number of baccalaureate prepared nurses, it is imperative that associate degree nurses be provided with user-friendly, affordable ways to attain a baccalaureate degree.

Tune in next week for part 2!


Aiken, L. H., Clarke, S. P., Sloane, D. M., Lake, E. T., & Cheney, T. (2008). Effects of hospital   care environments on patient mortality and nurse outcomes. Journal of Nursing            Administration (JONA), 38(5), 223-229.

Aiken, L. H., Sloane, D. M., Bruyneel, L., Van den Heede, K., Griffiths, P., Busse, R.,
.  .  .     Sermeus, W. (2014). Association of nurse staffing and education with hospital mortality   in 9 European countries. The Lancet, 383, 1824-1830.

American Association of Colleges of Nursing (AACN). (2014). Nursing faculty shortage fact       sheet. Retrieved April 21, 2017, from                nursing-facultyshortage

Health Resources and Services Administration (HRSA), (2013). The U.S. Nursing Workforce:     Trends in Supply and Education. Retrieved on April 21, 2017 from    2013.pdf

Institute of Medicine (IOM). (2010). The future of nursing: Leading change, advancing    health.  Retrieved from 12956&page=R1

Schekel, M. (2009). Nursing education: Past, present, future. In G. Roux & J. A. Halstead (Eds.),             Issues and Trends in Nursing: Essential Knowledge for Today and Tomorrow. Sudbury,   Mass.:Jones & Bartlett.