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Running head: REFLECTION ONE
Reflection One
Amanda Hagg
Liberty University
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REFLECTION ONE
Reflection One
With the baby boomer generation growing older and the need for nurses at an all-time
high in order to provide acute and chronic care to these individuals (Plawecki & Plawecki,
2015), the number of nursing programs throughout the United States has increased by 21% over
nine years from 2005 to 2014 in an attempt to meet the healthcare needs of our country. In 2005,
the total number of nursing programs in the US was 1,544. In 2014, the National League for
Nursing (NLN) reported 1,869 total nursing programs operating in the US. Of these, 67 offer a
diploma, 1,092 offer an associate degree, and 710 offer a bachelor’s degree (National League
for Nursing, 2014).
With three options to obtain an entry level education and opportunity to become licensed
as a registered nurse, it is important to understand the difference of each program and what they
could potentially offer to a prospective student. This paper will delve into the similarities and
differences of the curriculum of a diploma, associate’s, and bachelor’s program look like and
also discuss what each program may offer to its students.
Graham Hospital School of Nursing
The Graham School of Nursing, located in Canton, Illinois, is a program which offers a
diploma in Nursing. The program’s curriculum is spread over three years, two semesters in each
year. Each semester offers students the opportunity to take nursing courses as well as general
education courses, which are completed at the nearby Spoon River College. The total amount of
credit hours for this program is 89 hours, 50 of these hours in nursing and 39 in general
education.
The cost of this program is $43,136, which covers tuition, fees, books, and supplies.
Room and board are provided at a cost of $20,631. The program is also accredited by the
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Accreditation Commission for Education in Nursing (ACEN) and has been operating since 1909.
(Graham Hospital School of Nursing, 2019)
Harper College
Harper College is located in Palatine, Illinois and offers students an associate degree in
nursing program. This program consists of 68 credit hours over four semesters, or one-and-a-half
to two years. The core nursing curriculum consists of 37 credit hours. The cost to attend and
graduate from this program is ~$29,000. The school opened in 1967 and is also accredited by the
ACEN. (Harper College, 2020)
Trinity Christian College
Trinity Christian College, in Palos Heights, Illinois, offers a Bachelor of Science in
nursing degree program. This four-year program consists of an overall total of 120 credit hours.
Annual tuition for this school is estimated around $30,700 with room & board adding another
~&10,000 per year. Other costs include books, transportation, and miscellaneous expenses at
~$1,500 each annually. This school was founded in 1959 and is accredited by the Commission on
Collegiate Nursing Education, or CCNE. (Trinity Christian College, 2019)
Similarities
Each program stated above requires students to take general education courses related to
healthcare. These include anatomy & physiology, microbiology, psychology, sociology, and
nutrition. They also include a core of nursing courses that includes medical-surgical
nursing/acute care of the adult client, obstetrical, pediatric, psychosocial, and community
nursing. Each program also offers students the opportunity for hands-on clinical education
through local participating hospitals. It appears that the same information is being delivered
though some differences in course names and curriculum design do exist.
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Differences
The main difference between each program is the length and credit hour requirement. The
diploma program is completed over three years and requires 89 credit hours. The associate’s
program is a two-year program consisting of 68 credit hours, 14 being prerequisites. These
prerequisite courses can be taken at each student’s own pace before applying for the nursing
portion of this school. Lastly, the bachelor’s degree program is completed over four years with a
required 120 credit hours. Each “core curriculum” also consists of a different number of courses
and credit hours. The diploma requires 50 credit hours of nursing courses, the associates requires
37 credit hours, and the bachelor’s requires 56 credit hours.
While the three different degree programs are very similar in curriculum structure, the
bachelor’s program provides courses to elevate an entry level nurse’s practice. Courses such as
health promotion, therapeutic intervention, nursing research, and issues/leadership in nursing are
all offered through the bachelor’s program. While these subjects may be briefed on through the
diploma and associate’s programs, they are separated into different classes for increased content
and comprehension with the higher degree. Pathophysiology and pharmacology courses are also
offered through the associate’s and bachelor’s curriculum, but not through the diploma program.
I can only assume that these concepts and medications are covered in the appropriate classes
when discussing disease processes and/or treatments.
Furthermore, the diploma and associate’s programs are accredited by the ACEN while the
bachelor’s program is accredited by the CCNE. Accreditation is essential in transferring credits
(such as to further education), accessing financial aid, taking licensure exams, and obtaining
employment. The ACEN evaluates a school’s program based on the faculty’s qualifications, the
program’s plan of study, resources used throughout the program, plan for evaluation, and the
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course catalog. The CCNE evaluates schools based on missions and goals of the program,
performance of the students, utilization of resources, and integrity of the program. The main
difference between these two organizations is that the ACEN accredits all levels of nursing
programs while the CCNE only accredits bachelor’s and master’s programs.
Reflection
In 2014, I graduated from an associate degree in nursing program with the hope of
entering the workforce before obtaining a bachelor’s degree. Thankfully, this came to fruition
after passing the NCLEX and beginning my first position on a 32-bed medical-surgical unit. A
few months later, I was able to enter into a BSN program with the assistance of tuition
reimbursement from my current job. Unfortunately, many of my classmates struggled to find a
job in a city oversaturated with undergraduate nursing programs after graduating with an ADN.
The Institute of Medicine recommends that 80% of registered nurses have a bachelor’s
degree by 2020 and more hospitals are moving to make this a requirement of employment within
their organizations. This shift can be related to the higher quality patient outcomes related to
higher education in nursing (Sarver, Cichra, & Kline, 2014). Due to this, bachelor’s prepared
nurses are afforded more job opportunities than associate’s prepared nurses with the same
qualifications. In most facilities in my area, nurses who are hired with an associate degree are
required to sign a contract stating they will obtain a BSN within a certain amount of years
(typically three years).
So what factors influence an individual’s decision to choose a diploma, associate’s, or
bachelor’s nursing program? A study conducted at the Academy of Nursing in Belitung,
Indonesia surveyed 20 students of their diploma nursing program on their decision to attend the
school and their plans after graduation. More than half of the students cited financial and family
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obligations in their decision to obtain a diploma. More than half of these students also stated that
their plans following graduation included pursuing higher nursing education (Aungsuroch,
Gunawan, Sukarna, & Wahab, 2018). For myself, I knew that attending a full-time bachelor’s
program would be difficult for me as I would still need to work to provide for my family. I also
knew that I would want to immediately return to school following graduation to obtain a
bachelor’s degree and could potentially make this transition easier with financial assistance from
my future employer. These two factors fueled my decision to proceed with a program that would
award me an ADN to begin with. Through that decision, I have been able to complete my BSN
and am now working towards obtaining an MSN!
In regard to the NCLEX, I do believe that the same exam be given to all three levels of
graduate nurses. With the “core” part of the program being very similar, it is clear that the same
information is being taught and learned. I believe that a bachelor’s degree does not make you a
“better” nurse, only that it opens the door for increased opportunities and the ability to further
your education. In the long run, your path to nursing does not matter. What really matters is what
you take from your education to become the best nurse you are able to be.
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References
Aungsuroch, Y., Gunawan, J., Sukarna, A., & Wahab, N. (2018). Nursing students plan after
graduation: A qualitative study. Journal of Education and Health Promotion, 7(1), 1. doi:
10.4103/jehp.jehp_18_17
Graham Hospital School of Nursing. (2019). Curriculum. Retrieved March 22, 2020, from
https://www.grahamschoolofnursing.org/academics/curriculum
Harper College. (2020). Nursing. Retrieved March 22, 2020, from
https://www.harpercollege.edu/academics/health/nursing/index.php
National League for Nursing. (2014). NLN Biennial Survey of Schools of Nursing. Retrieved
March 22, 2020, from http://www.nln.org/newsroom/nursing-education-
statistics/nursing-programs
Plawecki, H. M., & Plawecki, L. H. (2015). The emerging baby boomer health care
crisis. Journal of Gerontological Nursing, 41(11), 3–5. doi:
10.3928/00989134- 20151015-22
Sarver, W., Cichra, N., & Kline, M. (2015). Perceived benefits, motivators, and barriers to
advancing nurse education: Removing barriers to improve success. Nursing Education
Perspectives, 36(3), 153–156. doi: 10.5480/14-1407
Trinity Christian College. (2019). Nursing Degree at Trinity Christian College. Retrieved March
22, 2020, from https://www.trnty.edu/academic-program/nursing/
