Associate-degree Level VS. Baccalaureate-degree Level in Nursing
Lisa L. Ramirez
Grand Canyon University: NRS 430-V
November 22, 2013

There are many differences in the nursing field between an undergraduate nurse, holding an associate’s degree (ADN) and a graduate nurse, holding a baccalaureate’s degree (BSN). The main focus of this paper is to identify the differences of competency in the nursing practice of nurses holding an ADN vs. a BSN degree in the roles of assessing, critical thinking, communicating, providing care, teaching, and leading. Competency is the ability to do something efficiently and successfully. Grand Canyon University (GCU) offers the BSN program and is based on the curriculum set forth by the College of Nursing. This curriculum is outlined to prepare the student to respond creatively to the continuously changing health care systems throughout the world. “Within this program, professionalism, ethical decision making, accountability, effective communication, and critical thinking are emphasized and is achieved by the application of liberal arts, science, health and nursing theories” (GCU). The Associate Degree Nursing curriculum provides knowledge, skills, and strategies necessary to integrate safety and quality into nursing care, to practice in a dynamic environment, and to meet individual needs which impact health, quality of life and achievement of potential, according to the community college of Piedmont.
According to an article from The Journal of Advanced Nursing, “How Can we Compare Graduate and Non-graduate Nurses,” states that the fact that the ADN and BSN programs are different in content and length does not differentiate them from practicing the in the same nursing roles. Graduates from both degrees take on the same roles in the nursing workforce, therefore leading to studies to differentiate BSN competency vs. AND competency. There are many studies that show higher competency and performance in nurses holding a BSN degree vs. a nurse holding an ADN degree. An example of these studies was constructed by Verhonick in which consisted of a paper and pencil test involving patient situations. The studied showed that the higher the education degree held, the likeliness that the nurse would demonstrate supportive actions to observations made. Another study used in Britain constructed by Crow, compared the two groups of nurses’ ability to identify nursing problems and apply interventions. Methods used to conduct this study was a problem identification test and a nursing intervention test. These studies results showed that a nurse with BSN education recognized more psychosocial problems and suggested more interventions. I believe this is because of the more in depth and detailed education the BSN programs provide versus the undergraduate nursing programs.
According to the American Association of Colleges of Nursing (AACN): “Creating a More Highly Qualified Nursing Workforce,” research has shown a decrease in patient mortality rates, positive patient outcomes, and less medication administration errors is correlated to nurses who are prepared at the BSN or graduate degree level. The AACN is has stated that they are working to create a more highly qualified nursing workforce due to studies showing that education increases clinical competency and more efficient delivery of patient care. As stated by an article in an issue of Medical Care in 2012, “researchers from the University of Pennsylvania found that surgical patients in Magnet hospitals had a 14% lower odds of inpatient deaths within 30 days and 12% lower odds of failure to rescue compared to patients care for in a non-Magnet hospitals. This outcome is related to their investments in employing highly qualified and educated nurses, where a high number of the nurses hold a BSN degree” (Creating a More Qualified Nursing Workforce). In another journal written in January 2007, Journal of Advanced Nursing, shows similar findings of those from Medical Care. This study conducted by researchers found that hospitals with higher quantity of BSN nurses tend to have lower 30-day hospital mortality rates. “Every 10% increase in the quantity of BSN nurses on hospital staff was associated with 9 fewer deaths for every 1,000 discharged patients” (Rosseter, R AACN).
There are many studies and research that shows how BSN prepared nurses are more qualified and competent to enter the nursing workforce that ADN nurses. I believe that a nurse with higher education is more prepared for the nursing workplace than one with an associate’s degree, because those nurses get more research experience and are theory driven to prepare them to critical think and lead in the nursing work place. As a new nurse with an associate’s degree I don’t feel as prepared as I should be. I feel like I am missing the leadership role and critical thinking. I am great providing safe bedside care, identifying change in a patient’s condition and addressing patient’s problems; but I lack the critical thinking of what’s causing the signs/symptoms the patient is experiencing. As I am starting this BSN program I feel the confidence that I will encounter the lack of leadership and critical thinking roles I seek.

References
Bircumshaw, D. (1989). How can we compare graduate and non-graduate nurses? A review of the literature. Journal of Advanced Nursing, 14(6), 438-443.
Holton, Catherine L. MSN, RN, CNE Central Piedmont Community College. Accessed on November 22, 2013. http://www.cpcc.edu/nursing
Grand Canyon University website. Accessed on November 22, 2013 http://www.gcu.edu/College-of-Nursing-and-Health-Care-Professions/Philosophy.php
Rosseter, Robert J. (Last Update: October 24, 2012). Creating a More Highly Qualified Nursing Workforce. American Association of Colleges of Nursing. Accessed on November 22, 2013 http://www.aacn.nche.edu/media-relations/NursingWorkforce.pdf