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Upasana Gupta -

Nursing: a Vocation or Profession?

Learn the Differences in a Two-Year vs. Four-Year Nursing Program

Is nursing a vocation or profession? This has been an on-going debate within the field. Students are still confused whether to consider nursing as an occupation and study two years toward an associates degree or consider nursing as a profession and take up the regular four-year degree program. So which one is it?

Suggested Read (Nursing Career in High Demand)

"We consider nursing to be a profession meaning you do need to have a bachelors degree to have a profession," says Linda Plank, Associate Dean of Academic Affairs at Baylor University Louise Herrington School of Nursing.

I think it's very important to know the history of nursing to understand how the field has evolved and why this debate still exists.

Nursing has been around for centuries, but it was not always considered a profession. Though women were accustomed to treating sick members of their family, they were not trained in the medical arts, but rather relied on handed down information from their mothers and grandmothers. However, as time passed and the value of women in nursing professions became more apparent, the building blocks of the nursing profession and formal training were laid out.

Even then, nursing remained as a vocation in the U.S. because in the past, majority of the nursing schools were part of a hospital set-up so they just hired people (mostly women) and trained them as employees.

"For our school, we made the decision in 1950 that we still wanted to be affliated with the hospital, but felt that a four-year degree was necessary to be the best nurse," Plank says.

What's interesting in the U.S. now, is that there are about half of the nursing schools which follow the bachelor of science in nursing degree. While the other 50 percent, adhere to a two-year program offering an associate degree in nursing based in junior or community colleges.

"We are half and half in the United States, that's not the same in other countries," adds Plank. "It's either one or the other - you don't get a choice."

Two Years vs. Four Years to Become a Nurse- What's the Difference?

As a veteran in the nursing field, Plank finds herself faced with this question for the past thirty years. "There is no easy answer for this," she says.

All candidates have to take up the same National Council Licensure Examination (NCLEX) irrespective of the two-year or four-year program. The National Council of States Board of Nursing requires all candidates to pass the NCLEX exam for licensure that measures the competencies needed to perform safely and effectively as a newly licensed, entry-level nurse.

Passing the NCLEX exam demonstrates a candidate's competence to be a good, bed-side nurse after two years of education. While, the candidates that go for a four-year program get the same basic understanding and skills like a two-year nurse, but "at a university setting with four years education, we teach and prepare candidates to be a good nurse beyond and outside the hospital setting," Plank says. " So besides being a good bed- side nurse in a hospital setting which two -year nurses are competent in, our students can take-up and run community clinics or be a missionary nurse and go to a country where they are or may be the only healthcare provider in the entire country."

Another difference in a two-year vs. a four-year nursing program is that the bachelors degree in nursing covers courses in research, leadership and community clinical, which is not covered in an associates nursing degree curriculum.

So a two-year nurse will not be qualified to do research based on their education. They can definitely take-up research after, but will not be prepared to do so upon completing a two-year program.  Also, they will not probably get a leadership position quite as fast because they may have not had any leadership theory classes or not had any experience with the nurse manager as a student.

"There is very little difference in the paient care and basic skills, but four-year students have the ability to advance faster, become leaders faster and go into research and not be just confined to a hospital setting," adds Plank.