Baccalaureate prepared nurses versus Associate prepared nurses
Shirley Jones

Baccalaureate prepared nurses versus Associate prepared nurses
What are the differences between baccalaureates prepared nurses and associates prepared nurses? This has been a topic for discussion for many years. Prior to the modern practice of nursing, the sick were taken care of by the less-than-desirable population such as “sinners, saints or mothers”. (L. Hover, lecture notes, June 2013). Times have changed since the days when prostitutes and women of ill repute or members of religious orders tended to the sick. (L. Hover, lecture notes, June 2013). In today’s nursing, no major differences are noted between the cognitive abilities of students in baccalaureate and associate degree programs (Davis-Martin, 1990). Baccalaureate nurses are generally seen as being better prepared for a wide range of nursing competencies and are seen as performing in the professional role in which they are prepared. Associate degree nurses are seen as performing well in the technical role for which they have been prepared, as well as in some leadership roles for which they were not originally prepared (Davis-Martin, 1990). One difference in competencies between the Associate Degree Nurse (ADN) and the Baccalaureate Degree Nurse (BSN) is the time spent in the formal education process. The associate prepared nurse usually obtains their degree from a community college or junior college whereas the BSN nurse attends a four year college or university. The ADN program mainly focuses on hands on training but it lacks the leadership and managerial skills that the BSN curriculum offers. The ADN program attracts a greater number of older students, minority students and men. Many nurses are happy with being an ADN since the program is less expensive and requires less classroom time and, most times, assures quick employment.
A study recently published in the Journal of the American Medical Association linked rates of surgical patient mortality to whether nurses had bachelor’s degrees. The study found that at 168 hospitals in Pennsylvania, “death rates were nearly twice as high at hospitals where less than 10% of nurses had bachelor’s degrees as they were at hospitals where over 70% did” (Aiken, Clark, Cheung, Sloane, & Silber, 2003). The data is compelling and cannot be ignored. There is no question that BSNs have a broader knowledge of the subject, nursing in general than their associate prepared counterparts. Other than the leadership and managerial aspect, I’m not sure there is much difference, clinically, especially when both nurses have been on the floor for a number of years. In the study of the Pennsylvania hospitals, I wonder how much experience all of the nurses had all together. I have worked with LPNs that could run circles around the associate’s prepared nurse and the bachelor’s prepared nurse. All in all, it comes down to experience. Even though bachelor’s prepared nurses come out of school with much a much broader knowledge base, I believe in time, with the same experiences they could be considered equals when it comes to patient care.
Patient care situations in which there could be a noticeable difference in the associate’s prepared nurse and the bachelor’s prepared nurse is in critical thinking. I haven’t seen many new graduate ADNs go straight into critical care or intensive care unit settings. The ones I have seen didn’t make it as often, feeling they “just weren’t ready”. The bachelor’s prepared nurse, coming right out of school, fares much better. They have a better understanding of critical thinking. The bachelor’s prepared nurse obtains a higher level of learning therefore providing a higher standard of care.
The Magnet Recognition Program was developed to promote quality and excellence in patient care delivery in hospitals by nurses in professional practice (American Nurses Credentialing Center, 2008). Magnet hospitals have a greater percentage of BSN prepared nurses than ADN prepared nurses and many hospitals are seeking Magnet Recognition (Aiken, Havens and Sloane, 2000). With so many hospitals wanting Magnet Recognition, it seems, to me, that nurses entering school should go straight for their BSN in order to avoid having to be pushed in that direction soon after graduating, if they can.
In conclusion, I wouldn’t be surprised if the associate’s prepared nurse is phased out over the upcoming years. If you’re an associate’s prepared nurse, not working, it is already very difficult to find employment. I would urge all associate’s prepared nurses to go back to school to obtain their BSN.

References
Aiken, L. H., Clark, S. P., Cheung, R. B., Sloane, D. M., & Silber, J. H. (2003). Educational levels of hospital nurses and surgical patient mortality. Journal of the American Medical Association, 290, 1617-1623. Retrieved from http://www.truthaboutnursing.org/news/2003/sep/26_ap.html
American Organization of Nurse Executives (2008). Position Statement. Retrieved January 27, 2008 from: http://www.aone.org/aone/resource/practiceandeducation.html
Davis-Martin, S. (1990, January). Research on the differences between baccalaureate and associate degree nurses. [Journal article]. NLN Publ. . Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/2406700