LPN to ADN or Beyond

As a Licensed Practical Nurse (LPN) you may be considering how to become a Registered Nurse (RN).  Like you, when I finished my practical nursing program I was faced with a number of options.  I could be content as a LPN, immediately enroll in an open enrollment RN program, begin a bridge program, or work for a few years and then either return to school or slowly class by class etch away at my RN degree.  Then there is the decision to pursue an Associate Degree in Nursing (ADN) and a Bachelors of Science in Nursing (BSN).  It’s a lot of big decisions!  I hope this article will help to equip you with enough pertinent information so you can make the best decision for your circumstances.  Let’s start by tackling the struggle between an ADN and a BSN.

ADN vs. BSN

  • Length of Schooling: (Full-time Curriculum)
    • ADN can be completed in 1.5-2 years
    • BSN will require at least 3-4 years
  • Opportunities for advancement:
    • ADN
      • Variety of home health, hospital and office work environments to choose from
      • Charge Nurse
      • Clinical Instructor (at some institutions)
    • BSN
      • The Institute of Medicine is expecting to increase the proportion of nurses with a baccalaureate degree to 80% by 2020
      • Work in specialty fields like forensics or case management
      • Faculty Teacher
      • Higher Administration than Charge Nurse

There are many other personal factors that weigh in on the decision but those are the major differences to consider.

Selecting a Program

In this section we will discuss the differences between online or on campus and specific program options available to you as an LPN.   Not contingent to a specific program each contain three basic components.   First, the didactic or theory component is imparted in the classroom (brick and mortar or online).  Second, the lab component is hands on practice but performed on manikins and with recourse materials, fellow students and nursing instructors aplenty.  Third, the clinical component is completed at a hospital where students get to interact with real patients.  While comparing online and on campus programs it is important to keep in mind that that no program can incorporate all three components and be 100% online.

Online vs. On-Campus Nursing Programs

  • Scheduling:

No nursing program will be easy on your life.  All will require a strict, tight schedule.  Later we will specifically discuss scheduling as a key to surviving a nursing program.  For now we will see specific considerations based on which program you choose.

  • An online program:
    • Is more flexible with scheduling
    • Requires less time
    • Demands self-motivation and discipline to complete assignments by their deadlines
  • An on campus program:
    • Schedule is set, while evening and weekend classes may be available
    • Requires more time (example: commuting to campus and traffic, etc.)
    • Provides some motivation and discipline by peers and frequent face-to-face interaction with instructors along with down time between classes available to complete assignments with fellow students
  • Cost:
    • Online ADN programs range from $28,000 like Baker College in Michigan to about $40,000 at Orion College in Florida (https://orioncollege.org/tuition/tuition-fees/)
    • On campus programs as discussed above range $10,000-$40,000
  • Student Interaction:
    • An online program is a more isolated program, although there is time to associate with your peers during clinical rotations and lab work. Keep in mind this time is constantly in demand by patients and the opportunity to learn.  It is not designed or provided for student interaction.
    • An on campus program allows more time to foster relationships with fellow students and instructors. In “A Case Study of Factors Leading to Student Success in an Accelerated Licensed Practical Nurse to Associate Degree Nursing Program” performed at Liberty University the research showed “that faculty-student relationships, and support from peer nursing students are important factors in students’ being successful.”  Specific factors related by the students was the “confidence needed to continue in the program” and help from fellow students to complete assignments on time.

Factoring your individual learning style and demands on your personal time you can choose which option is best for you.  In addition to online and on campus courses there are also variations available to you as an LPN.

LPN to ADN Program Options

LPN to ADN Bridge Program

A bridge program is tailored to a LPN obtaining their ADN degree.  This takes into account your previous medical training and work experience.

  • Length:
    • 1-1.5 years for an ADN and 2-3 years for a BSN
  • Pros:
    • Some programs are hybrid online option with multiple start dates every academic year
    • Specific focus given to honing critical thinking and working autonomously
    • Potentially able to test out of some courses and obtain clinical credits based on work experience
  • Cons:
    • Some bridge programs are integrated with the open enrollment ADN program just with a later start date, which means if you are not accepted it may be too late to enroll in another program in the same academic year
    • Competitive application process, instead of competing with a general admission pool you are only compared to other LPNs

Accelerated LPN to ADN Nursing Programs

An accelerated nursing program is designed for individuals with a non-medical degree (bachelors or higher) who would like to obtain their BSN or MSN.  If obtaining your LPN was a career change this might be a great option for you!

  • Length:
    • Accelerated baccalaureate program requires 11-18 months, or 3-4 semesters
    • Accelerated master’s degree program spans 3 years, some programs offer a BSN at the conclusion of the first year
  • Pros:
    • Programs are tailored to motivated professionals and student body make-up is unique
    • Making use of your undergraduate education to support advancement in another career
    • Comparatively short amount of time
  • Cons:
    • Vigorous, taxing schedule
    • Some find it difficult to transition from the role of a professional to the role of a student
    • There is limited financial aide
  • Admission requirements:
    • 0 Grade Point Average (GPA) from all previous undergraduate credits
    • Due to the rigorous schedule students are encouraged not to work this is discussed as part of the admission process
    • An in-person interview is required to assess available support systems, learning abilities related to this unique learning environment and course specific evaluations, for example the interview for a hybrid course will include a test of the applicants computer skills and independent learning ability

Open Enrollment Nursing Program

An open enrollment program requires neither a LPN nor non-medical bachelors degree and is open to a general admission pool.

  • Length:
    • See previous discussion regarding ADN vs. BSN subheading “Length of Schooling”
  • Pros:
    • Admission requirements are less ridged as compared to the other two options
    • If there were concepts during your practical nursing training that you had difficulty grasping, repeating the information can help you have a better grasp of them
    • You can work as an LPN while enrolled in the RN program and perform the skills you are discussing in class (as long as they are inside your scope of practice)
  • Cons:
    • Curriculum is geared to the general public, not requiring a medical license or previous college experience, as an LPN some courses could feel tedious
    • As an LPN you are paying money and spending time retaking courses that you have already completed
    • Considering the variety of a general enrollment student population as an LPN you might be viewed as a resource and not feel free to ask questions or, on the other extreme, as an outsider who doesn’t understand how overwhelmed the other students feel and who skews test averages, it depends on the class make-up

As you can see, there are many roads that will lead you, as an LPN, to your RN degree.  Make sure you check what options are locally available and then weight the pros and cons with your personal circumstances.

Surviving LPN to ADN Program

Once you have decided on a program the real work begins!  Let’s discuss five tips on how to survive this intense educational experience.

Benefits of Prior Healthcare Experience

Over the past 10 years, there has been a shift in ADN programs requiring prior healthcare experience.  A thesis paper written by a nursing student at The Ohio State University entitled: “Combatting the Nursing Shortage by Requiring Prior Healthcare Experience as a Condition of Admission to Nursing School: a Systematic Review” correlated data from 15 years of research.  It states, “The findings of this literature review reveal various advantages and disadvantages related to nursing students having previous healthcare experience prior to beginning nursing school.”  As an LPN you have prior healthcare experience, even if only from the clinical setting.  The following advantages and disadvantages are discussed in the article.

  • Advantages:
    • Increased confidence
    • Decreased levels of stress and anxiety
    • Exposure to the reality of the field leading to lower levels of attraction
  • Disadvantages:
    • Role confusion and treatment on the unit
    • Academic impact
    • Student perception of learning needs

As an LPN it would be wise to seriously consider these disadvantages and how much impact they will have on your personally.  This way you can ensure your previous healthcare experience will be a benefit and not a hindrance.

Time Management Key to ADN Program Success

As discussed in the section Online vs. On Campus under the subheading “Scheduling”, all nursing courses are highly demanding on your time.  In a Case Study entitled “The Relationship Between University Nursing Student Classroom Engagement Activities and Academic Performance”, a percentage of students specifically identified that “time management skills attributed to their success in the nursing program”.  The question is how to do it.  Here are a few tips that I found helpful as I pursued my nursing degrees.

Be realistic and flexible.  You are going to get sick.  There will be an accident on your way to your clinical setting.  At some point your patient will complain of chest pain before you even get report.  Learning to be realistic with your expectations, whether it is a student assignment, a 12-hour shift or making a family dinner, is good for your mental health and continued personal growth.  Flexibility is absolutely necessary, however without understanding how to prioritize flexibility could be a liability.

Prioritize.  If you have mastered this as an LPN you are light-years ahead of most new grads.  At some point everything will go awry.  Learn to accurately prioritize for the situation.  In the hospital setting a vomiting patient compared to a patient with new chest pain might be less important, whereas at home a vomiting child might be more important then studying for a test.  Both cases require prioritizing a vomiting individual but the situation and circumstances are different.  When making your schedule, identify your most important things.  These will vary person to person.  As long as your most important things are completed at the end of the day, you can go to bed happy!

Know and respect yourself.  You are an adult.  If you are a night owl don’t get up to study at 4am.  If you don’t have to study for 3 hours to pass a test, don’t!  Make little rewards for yourself.  Occasionally, it can be food but that is a bad habit that’s hard to break.  Try to think outside the box and really make it rewarding for you!  Put your rewards into your schedule and respect your own needs.

How to Study for Your LPN to ADN Program Like a Pro

Make the best use of your study time.  Your time is a precious commodity.  When it’s time to study, STUDY!  Turn off your cell phone.  Don’t have the television on.  Make sure it’s quiet or, if silence distracts you, play lyric free music.  Put a sign on the door asking your family to respect your study time or if possible, schedule study time when no one is home or awake.  Gather everything you need to study: a drink, maybe snacks, your books, your notes or tablet, etc.…whatever you need, gather it all before you start studying, so you can really focus.  If you still have your notes from your LPN program have them available to reference.

Take needed breaks.  If you are interested in scientific studies related to the vigilance decrement you can read this article published by the Human Factors and Ergonomics Society in association with the U.S. Army or this one published by the University of Illinois.  If you want less scientific, here is an article in the Huffington Post or The Muse or The University of New Hampshire.  What is comes down to is we can only focus on the same thing for a little less then an hour then we need a 15 minute (or so) break before we can refocus.  If your studies of the human pathophysiology teach you anything you know we are all a bit different and you will have plenty of time to determine your most productive study:rest ratio.  When you rest, don’t just sit there looking at Facebook, get up and dance or stretch or do some dishes then get back to studying.

Prioritize.  At the beginning of each study session make a goal of what you need to understand better.  If you are preparing for a lecture this will be different than reviewing for a test.

Preparing for a lecture

Casually read the introduction to the chapter.  With the theme in mind read the subheadings.  As an LPN, ask yourself, “Can I explain how this works?” or try and describe the process.  Circle or highlight each subheading title that you don’t remember or can’t explain.  Cross-through or leave un-highlighted subheading titles you feel you have a grasp on.  To help make the distinction if there are review questions for a section see if you can answer them all in your own words.

For example:  Your next lecture is focusing on the Musculoskeletal System.  You are assigned to read a chapter about the management of problems related to mobility.  If you have been working at a long-term care facility you would probably highlight or circle the subheading title discussing clubfoot and other food and leg deformities in infancy and early childhood but cross through a subheading title discussing special considerations in the geriatric population.  However, if you had been working at a pediatrician’s office it might be the opposite.

Now start at the first subheading and if it is highlighted read it carefully.  Make notes if something is unclear so you pay special attention during the lecture.  If you have a hard time understanding the information reference notes from your LPN education or other classes, like Anatomy and Physiology (A&P).  If you find you’re A&P textbook has a picture or explanation you understand better make a note of that for use during the lecture or during review.  Pay special attention to information in the boxes.  If it is a subheading that you left un-highlighted or marked through read the topic sentence (which is the first sentence) of each paragraph.  This is a multi purpose task.  It allows you to be prepared for the lecture and allows your brain to place the information mentally on the page.  It also serves as a double check that you do understand all the information in that subheading without reading the entire paragraph.  If you read the topic sentence that mentions something you forgot, didn’t realize would come under that subheading or contains updated information read it and continue on.  If you don’t have enough time in your study session to do all of these steps just focus on the subheadings you have highlighted.

Test Preparation for ADN Classes 

Start at the end of the chapter with the review.  Use the same method as preparing for a lecture.  If you can answer all the questions under one section don’t spend all your time on that but focus on the sections you can’t answer.  Use other review tools like NCLEX style questions or the accompanying workbooks for your nursing textbook.

When you are listening to a lecture indicate what points were made to stand out.  For instance, whenever one of my professors said, “You should review this before the test.”  I highlighted that in purple with big arrows pointing to it.  Then when I was studying for that test if I saw purple I spent more time on that point.  Either keep a separate notebook that you can jot down page and paragraph numbers or highlight in a color that is ONLY for test review or if you take audio notes mark it with a time stamp.  If your professors don’t give you an obvious verbal cue, pay attention to what they spend proportionately more time explaining.

Melding nursing school with your life is no easy task, but it is possible.  Even though your life circumstances may be different now, as an LPN, you have been through it once and survived.

In this article, we have discussed the many options open to you as an LPN along with lots of specific considerations.  I hope this information helps you to make the best decisions for your personal circumstances and helps prepare you to successfully obtaining your RN degree!

ADN vs. BSN
Online vs. On-Campus Nursing Programs
LPN to ADN Program Options
Surviving LPN to ADN Program
Time Management Key to ADN Program Success
How to Study for Your LPN to ADN Program Like a Pro
Test Preparation for ADN Classes