Competent Nurses - ADN Versus BSN Qualified
ISAAC GEORGE
GRAND CANYON UNIVERSITY
Professional Dynamics
NRS-430V
Monica Kidder
April 07, 2013 A Competent Nurse, an ADN or BSN.
Nursing as a profession is vast, multifaceted, yet independent. Even though the nurse may work independently, he or she works in collaboration, collectively with a host of professionals from various departments, families, and the community as a whole. The main goal being to educate, and equip for better overall health of everyone including the healthy, sick, handicapped or dying. To help with the advancement of nursing, to accept changes, incorporate new technologies and, to be actively involved in the betterment of every sphere of our society.
The question on every nurses mind that comes out of a 2 year ADN (Associate Degree Nursing ) program is, “Why do I have to go through 2 more years of school to get a Bachelors Degree in Nursing, when I have already cleared the NCLEX and got my RN license , the same license that qualifies a Baccalaureate nurse to be qualified as a Registered Nurse?” It’s a very good question, and a very apt one. During the course of this essay, we are going to look at the difference between these two levels of education and figure out the advantages of an advance degree, if there are any based on research.
To do an in depth analysis between these two programs we will have to look at the difference between the actual programs. Associate degree nursing programs have a duration of 2 years, and keep a balance between general and clinical nursing. The intent of this 2 year program was to prepare technical nurses, with more bedside skills for rural settings, nursing homes or small hospitals. 4 year Bachelor degree programs , consists of upper division level courses, Graduates at this level are prepared in general to have leadership qualities with the intent of stepping in to that shoe one day. According to Leddy and Pepper’s Conceptual Bases of Professional Nursing, 2 year associate programs lay more emphasis on technical skill and well laid out proven methodology in terms of patient care which in turn can lead to nursing that is too curriculum oriented with no critical thinking involved on the nurses part. Nurses with an A.D.N tend to follow the chosen path, without looking for new ones, even if it comprises patient safety. For example: “A patient may not get his pain medications, since sufficient time has not elapsed after the first dose was given.” (Hood, 2010, p. 17) On close inspection ,we see the BSN program is geared more towards nurses assuming a leadership role, be it in the clinical side or the management side of their profession. To quote Sara Ellis, “BSN prepared nurses possess greater knowledge of health promotion, disease prevention, risk reduction as well as illness and disease management, and are prepared to assist individual groups and communities to prevent disease and achieve optimum level of wellness.”(Ellis, n.d, p. 1) Nurses with an associate degree are geared more towards bedside skills and , cater to clients that have simple diagnosis with a set course of treatment. Bachelor’s degree holders on the other hand can work in a variety of settings and handle patients with complex disease processes. A BSN holder because of their advance degree is able to come up with patient specific plan of care and, therefore is more apt at providing efficient care, resulting in shorter hospital stays leading to increased profitability for the hospital. The extra emphasis on arts and statistics in the bachelors program , prepares nurses to use advanced communication and analytical tools enabling nursing care based on research.
In recent years there has been conclusive evidence showing decrease in the number of hospital related deaths as a result of advance level of education for nurses. These studies further validate the fact that nursing education positively impacts the care that a patient gets and how the patient outcome turns out to be.
One of the important published study out there that goes to prove the aforementioned was done by Aiken , Clarke, Cheung, Sloane, and Silber (2003). This study was conclusive in its findings that, in an acute care setting where 50 percent of the nurses have a bachelors degree; the rate of hospital related deaths reduced by 5 percent, further the survival rate for patients with hospital acquired pneumonia and pulmonary infections were vastly reduced.
Another published study in the May 2008 issue of the Journal of Nursing Administration by Dr. Linda Aiken and her colleagues at the University of Pennsylvania further validated this point. In this study they found that even a 10 percent increase in the proportion of nurses holding a bachelors degree decreased the risk of patient death and failure to rescue by 5%. (AACN, 2012, p. 2)
To further prove the point I would like to use a clinical situation. A 65 year old male comes to the ER with a complaint of knee pain and swelling for 2 days, with a sudden onset. Fever of 99.0. No history of injury. The triage nurse who happened to be an ADN, thought the patient was having an infection in the knee due to the swelling, pain, redness and warmth and gave the patient an acuity level of three. The patient is assigned a bed in the ER and another nurse who is a BSN, while examining the patient notices that he has swelling to the upper leg. On further examining and collecting information from the patient it is known that the patient also has been having swelling and pain to the calf and groin area. This nurse brings it to the ER physicians attention, who orders a CT scan. Eventually the patient is found to have septic arthritis of knee and multiple DVT’s to the upper and lower leg. Had we gone with the assessment of the first nurse, this patient would have probably gone home on antibiotics which would have led to worsening of his condition and possibly even death. The additional education of the BSN nurse helped her to critically think and evaluate and, go further with the information that she had from the ADN nurse to reach an outcome.
Nursing is a wonderful and rewarding profession. A BSN education will go a long way in helping nurses to provide professional nursing services, and in turn will help patients to get the best possible care References
American Association of Colleges of Nursing (AACN). (2012). Fact Sheet: Creating a More Highly Qualified Nursing Workforce, www.aacn.nche.edu/media-relations/NursingWorkforce.pdf
Creasia, J. L., & Friberg, E. E. (2011). CONCEPTUAL FOUNDATIONS: The Bridge to Professional Nursing Practice (5th ed.). [Adobe Digital Editions version]. Retrieved from http://www.elsevier.com
Ellis, S. (n.d). To BSN or not to BSN – That is the Nurse’s question!. Retrieved April 6, 2013 from http://www.articlegeek.com/reference/education_articles/bsn-nurse-question.htm
Hood, L. J. (2010). Leddy & Pepper’s: Conceptual Bases of Professional Nursing (7th ed.). PA: Lippincott Williams & Wilkins.