Grand Canyon University: NRS-430V
December 2, 2018
There has been a debate over the years about the different competencies between Associates Degree Nurses (ADN) versus Baccalaureate Degree Nurses (BSN). Nursing approaches to decision-making differs based on the educational preparation of the BSN nurse versus a diploma ADN degree.
Evolution of Nursing
Nursing practice has changed dramatically over time to help the effectiveness of medical care. The nurses today need to be well-educated and critical thinkers in comparison to the nurses years ago because they have a more complex role today. Regardless of the many advancements in nursing, the art of nursing remains as it was. (Whitney, 2018). Florence Nightingale was a nursing pioneer who helped advance the practice of nursing as a profession. (Whitney, 2018). Evolution has changed the scope of practice for nurses by using evidence base practice to improve quality outcomes and provide safe patient care for patients. The approach to treating individual’s today view of nursing as a profession is described as applying evidence base practice (EBP) with acceptable social aspects of care. (Dean, 2018). The skill sets and roles for nurses have evolved and will continue to change. Critical thinking will always be in the practice of nursing. With the changes in nursing, nurses will have to continue to collaborate effectively, determine conflict with skills, and use evidenced base practice to efficient and effectively deliver quality care. The development of EBP will be moving nursing and healthcare by holding nurses accountable in safety and quality improvements in healthcare. Nurses today will have to learn to adapt to the changing roles across the continuum of care.
Education on Nursing Practice
In comparing associate and baccalaureate education in nursing, the bachelor’s level BSNs and associate level ADNs both degrees practice as Registered Nurses (RN). After reading, “The Impact of Education on Nursing Practice” by Rosseter (2017), there are three routes registered nurses can take. The first is to enter into a 3-year diploma program which is typically administered in hospitals, the second is to enter into a 3-year associate degree at a community college, and the 3rd is enter into a 4-year baccalaureate degree at a university. All three routes result in taking the same National Council Licensing Exam-Registered Nurse (NCLEX-RN) licensure exam. In contrast, BSN programs consist of all of the course work taught in an ADN program but the BSN program is focused on theory and research. In addition, students in the BSN program are prepared with a broader scope of practice and a better understanding of the cultural, political, economic, and social issues that patients and influence delivery of healthcare. There is a growing body of evidence that shows that BSN graduates bring unique skills to their work as nursing clinicians and play an important role in the delivery of safe patient care. (Rosseter, 2017). Due to more education, the BSN nurse is more of a critical thinker, advanced in daily nursing tasks, and will avoid deadly errors. “Research has shown that lower
Decision-making differences between BSN-prepared nurse and ADN nurse
The patient care situation that comes to mind for me would be when I was in nursing school and I had a patient in labor and delivery that had a slightly elevated blood pressure (BP) prior to her pregnancy but with diet modifications she was unable to avoid blood pressure medications. On admission, the physician ordered a PRN BP medication in case she needed it. During the labor process, her BP starts to rise slightly. The ADN nurse comes in and see’s the BP reading, looks at the orders, and dispenses the BP medication as ordered because that’s what she was trained to do. Whereas the BSN nurse comes in and see’s the same BP reading but notices the patient appears in pain and is very upset. The BSN nurse asked the patient if she was having an increase in her pain level and offered her some pain medication because that may decrease her BP reading. Sure enough, that worked and the BSN nurse was able to avoid giving the patient another medication. In this situation, the BSN nurse looked farther into what was increasing the patients BP rather than just being task oriented and dispensing the BP medication unlike the ADN nurse.
According to “The Impact of Evidence-Based Practice in Nursing and the Next Big Ideas”, The recommendation that nurses lead interprofessional teams in improving delivery systems and care brings to the fore the necessity for new competencies, beyond evidence-based practice, that are requisite as nurses transform healthcare. (Steven, 2013). Applying EBP encourages us as healthcare professionals to use the best evidence possible to achieve a better outcome for our patients. The academic preparation of the RN-BSN nurse supports the application of EBP movement because the BSN programs are teaching and implementing core competencies for health professions such as provide patient-centered care, work in interdisciplinary teams, employ EBP, and apply quality improvement.
Today’s Nurses Collaborate
Some of the basic nursing competencies include collaboration, communication, education, environmental health, ethics, evidence-based practice and research, leadership, professional practice, quality of practice, and resource utilization. (Dean, 2018). In the May 2008 issue of the Journal of Nursing Administration, Linda Aiken and her colleagues confirmed the findings from their landmark 2003 study, which show a strong link between RN education level and patient outcomes. The noted nurse researchers found that every 10% increase in the proportion of BSN nurses on the hospital staff was associated with a 4% decrease in the risk of death. (Rosseter, 2015). Effective communication and collaboration with interdisciplinary teams leads to positive outcomes and a safer environment for the patient and team. Nurses that have their BSN support safer and more effective patient outcomes due to their competencies level.
ADN and BSN nurses are not different in skill competency when they graduate, but years later, the BSN nurse will show greater critical thinking skills, better problem solving, and the development of clinical judgement. BSN nurses’ competencies levels are much higher than an ADN nurse. Obtaining a BSN can open up more job opportunities, make you more desirable to employers, and have the option of moving into management positions.
Grand Canyon University (Ed). (2018). Dynamics in nursing: Art ; science of professional practice. Retrieved from https://lc.gcumedia.com/nrs430v/dynamics-in-nursing-art-and-science-of-professional-practice/v1.1/
Rosseter. (2015). Creating a more highly qualified nursing workforce. American association of colleges of nursing (AACN). Retrieved December 1, 2018, from http://www.aacnnursing.org/News-Information/Fact-Sheets/Nursing-Workforce
Rosseter. (2017). The impact of education on nursing practices. American association of colleges of nursing (AACN). Retrieved December 1, 2018, from HYPERLINK “http://www.aacnnursing.org/News-Information/Fact-Sheets/Impact-of-Education” http://www.aacnnursing.org/News-Information/Fact-Sheets/Impact-of-Education
Stevens, K., (May 31, 2013) “The impact of evidence-based practice in nursing and the next big ideas” OJIN: The Online Journal of Issues in Nursing Vol. 18, No. 2, Manuscript 4. Retrieved from http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-18-2013/No2-May-2013/Impact-of-Evidence-Based-Practice.html