Differences in Competencies Between ADN’s and BSN’s
Janice M. Montoya
Grand Canyon University: NRS-430V Professional Dynamics
January 14, 2012

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Introduction
Nursing is a profession that is ever changing. Early historian nurses are accountable for many of the changes and progression that we see today. We as well are equally responsible for this progression of the nursing profession. One example of the progression in nursing was the start of the Associate degree of nursing program. The nurses who finish this program are known as ADN’s. Since the ADN program was initiated there have been many debates on the differences between ADN’s and Bachelor degree nurses (BSN’s). Where does this topic stand today? What does the future hold for the ADN’s?
History of the ADN Nursing shortage has been a challenge in nursing through out time. In 1951 Mildred Montag developed a two year associate degree program for nurses. The purpose of this program was to help with the nursing shortage. Studies were done five years after of the start of this program and showed it to be successful because these nurses demonstrated clinical competency. Today the ADN program still exists. ADN’s are expected to take and pass the same state licensure exam as BSN’s. When passed, the same license is issued to the ADN as the BSN. Both can apply and be considered for entry level nursing positions. This has led to much confusion in the eyes of the public and in the world of nursing. What is the difference between ADN’s and BSN’s?
Educational Differences The associate degree program is a two year degree program and is typically offered through a technical school. The focus is mainly on clinical bedside nursing and skills. The

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BSN, Bachelor of Science in nursing is a four year degree program which is offered by universities and colleges with nursing schools. Bachelor programs encompass all the course work taught in an associate degree program but also included are theory, research, and methodology. More specifically, Physical and Social Sciences, Public and Community Health, Nursing Management, and Humanities. According to the American Association of Colleges of Nursing (AACN), the additional course work enhances the student’s professional development, prepares the new nurse for a broader scope of practice and provides the nurse with a better understanding of the cultural, political, economic, and social issues that affect patient’s and influence health care delivery. (AACN, April 2011). The obvious is there is more course work involved in the BSN program compared to the ADN program which typically takes two more years to complete and in the end each have the same license and legal responsibilities.
Clinical Differences
At the bedside the differences between ADN’s and BSN’s is vey little. Both come out of their education with the same basic beginning skills. Most skills are learned on the job and during practice. Both are trained in the same manner. To say the least there is very little difference in this area as far as entry level positions go. The title is the same, the pay is the same and the responsibilities are the same. In the area of management, there are some difference. ADN’s and BSN’s can both be considered for a charge nurse position. It has more recently been said that those who hold a charge nurse position with an ADN are highly encouraged to pursue their education to obtain their BSN. Higher managerial Montoya page 3 positions require a BSN or higher and therefore an ADN would not be considered for these positions.
Nursing Approach in Patient Care Nursing approach in patient care may be somewhat different. I do see more confidence and self assurance in the approach to patient care between ADN’s and BSN’s. This difference in approach may be due to the additional education obtained in the BSN program. These nurses have higher critical thinking skills than those who hold an ADN. One example is that the BSN’s may be able to think outside of the box., anticipate and know when to ask questions and research further for the benefit of the patient’s well being. I have experienced this during report; a nurse asking critical questions or collaborating with the doctors in certain situations. According to research Pardue(1987) and Scoloveno (1981) reported that baccalaureate students, when compared with associate degree and diploma students, showed higher critical thinking scores. (Shin, Jung, Shin, Kim, 2006). I ask myself if an ADN can develop these skills to some degree; if one can learn through experience or example. I myself know that I have learned so much through my years of experience and through that of examples set by my fellow colleagues. However, I do know that those experiences can not replace a formal education.
The Future of Nursing
What does the future of nursing hold for us as nurses and society? Fifteen years ago when I became an ADN I was often told that the only differences between and ADN and BSN was the degree. Everything else was the same. At that time I only contemplated returning back to school for personal reasons. There was no real incentive. Today I have a Montoya Page 4 different view. The world of nursing is evolving. Job postings are no longer reading BSN “preferred” but “required”. In a very recent article in Nurse.com, the Institute of Medicine (IOM) states nurses “should achieve higher levels of education and training through an improved education system that promotes seamless academic progression”, innovative ways to meet the demand for educating RN’s are a necessity (Domrose, 2012). With the ever changing health care system, this is the wave of the future. It will not be long before all entry level RN positions will require a minimum of a BSN.
Conclusion
After reading and researching the differences between an ADN and BSN I have come to change my way of thinking. I now know that there are many benefits to having a BSN. Not only will it open up opportunities for advancement but it will help enable me to become a critical thinker and allow me to deliver better care to those in need.

References
Conceptual Foundations: TheBridge to Professional Nursing Practice (5th ed.) St. Louis, MO: Creasia, Joan L, Friberg, Elizabeth E.
American Association of Colleges of Nursing (AACN) Fact Sheet: Creating a More Highly Qualified Nursing Workforce. http://www.aacn.nche.edu/media-relations/factsheet/nursing-workforce. April 2011
Schank, Mary Jane. Stollenwerk, Ruth. (1988) The Leadership/Management Role: A Differentiation Factor for ADN/BN Programs? The Journal of Nursing Education Vol. 26 No. 6, 253-255.
Shin, Kyungrim. Jung, Duk Yoo,.Shin, Sujin. Kim, Myoung. (2006) Critical Thinking Dispositions, and Skills of Senior Nursing Students in Associate, Baccalaureate, And RN-to-BSN Programs. Research Brief. Journal of Nursing Education Vol. 45 No.6, 233-236.
Domrose, Cathryn. (2012) RN 2020 Vision Nursing’s Future State Projects Find Creative Ways to Meet IOM Education Goals. Nurse.com A Gannett Company Nurse Week West. 21-23.